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Carpal Tunnel

C Liam Dwyer, Maximillian Soong, Alice Hunter, Jesse Dashe, Eric Tolo, N George Kasparyan
PURPOSE: We investigated whether written guidelines for surgeons and educational handouts for patients regarding safe and effective opioid use after hand surgery could reduce prescription sizes while achieving high patient satisfaction and a low refill rate. METHODS: All patients undergoing isolated carpal tunnel release or distal radius volar locked plating in a hand surgery group practice during a 6-month period were prospectively enrolled. Surgeons prescribed analgesics at their own discretion based on written guidelines...
March 12, 2018: Journal of Hand Surgery
Christoph Niemietz, Christoph Röcken, Matthias Schilling, Jörg Stypman, Constantin E Uhlig, Hartmut H-J Schmidt
Transthyretin-related Familial Amyloid Polyneuropathy (ATTR Amyloidosis, former FAP, here called TTR-FAP) is a rare, progressive autosomal dominant inherited amyloid disease ending fatal within 5 - 15 years after final diagnosis. TTR-FAP is caused by mutations of transthyretin (TTR), which forms amyloid fibrils affecting peripheral and autonomic nerves, the heart and other organs. Due to the phenotypic heterogeneity and partly not specific enough clinical symptoms, diagnosis of TTR-FAP can be complicated...
March 2018: Deutsche Medizinische Wochenschrift
Young Hak Roh, Young Do Koh, Jong Oh Kim, Kyu Ho Lee, Hyun Sik Gong, Goo Hyun Baek
BACKGROUND: Postoperative pillar pain (deep-seated wrist pain worsened by leaning on the heel of the hand) sometimes occurs after carpal tunnel release (CTR), leading to weakness in the hand and delayed return to work. Increased pain sensitivity has been found to be associated with worse symptoms and poorer treatment response in a number of chronic musculoskeletal conditions, but few studies have investigated the association of pain sensitization with pillar pain after CTR. QUESTIONS/PURPOSES: (1) Is preoperative pain sensitization in patients with carpal tunnel syndrome (CTS) associated with increased severity of pillar pain after open CTR? (2) What other demographic, electrophysiological, or preoperative clinical characteristics are associated with pillar pain after CTR? METHODS: Over a 35-month period, one surgeon performed 162 open carpal tunnel releases...
April 2018: Clinical Orthopaedics and related Research
Hussam Abou-Al-Shaar, Mark A Mahan
No abstract text is available yet for this article.
2018: Surgical Neurology International
Aoife Healy, Sybil Farmer, Anand Pandyan, Nachiappan Chockalingam
BACKGROUND: Assistive products are items which allow older people and people with disabilities to be able to live a healthy, productive and dignified life. It has been estimated that approximately 1.5% of the world's population need a prosthesis or orthosis. OBJECTIVE: The objective of this study was to systematically identify and review the evidence from randomized controlled trials assessing effectiveness and cost-effectiveness of prosthetic and orthotic interventions...
2018: PloS One
Farnaz Dehghan, Shila Haghighat, Hadiseh Ramezanian, Mehdi Karami, Mohammad Reza Rezaei
Background: The aim of this study is to determine the predictive value of ultrasonography for results of local steroid injection in patients with carpal tunnel syndrome (CTS). Materials and Methods: This prospective cohort study was conducted during a 1-year period in outpatient clinics of rehabilitation and physical medicine including 35 patients with moderate and severe CTS who receive ultrasonography-guided local steroid injection. The Boston self-assessment questionnaire and electrodiagnosis parameters were recorded at baseline, 1 month, and 3 months after therapy...
2018: Advanced Biomedical Research
Nishant Ganesh Kumar, Nicholas Hricz, Brian C Drolet
BACKGROUND: Carpal tunnel release (CTR) is the most common hand surgery operation performed in the United States. While serious complications are rare, they can be life-altering to patients. In some cases, patients will pursue malpractice claims against the surgeon. This study aimed to understand the patient, procedure, and surgeon factors involved in CTR malpractice litigation. METHODS: The Westlaw legal database was queried for all recorded CTR malpractice cases resulting in jury verdicts and settlements...
March 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Brigitte Tampin, Jan Vollert, Annina B Schmid
OBJECTIVE: Distal and proximal entrapment neuropathies such as carpal tunnel syndrome (CTS) and cervical radiculopathy (CR) share similar etiologies. Experimental models suggest that despite comparable etiology, pathomechanisms associated with injuries of the peripheral and central axon branches are distinct. This study therefore compared self-reported and elicited sensory profiles in patients with distal and proximal entrapment neuropathies. METHODS: Patients with electrodiagnostically confirmed CTS (n = 103) and patients with CR (n = 23) were included in this study...
March 10, 2018: Current Medical Research and Opinion
Lisa Whitehead
No abstract text is available yet for this article.
August 31, 2017: International Journal of Nursing Studies
Yasemin Eren, Neşe Güngör Yavasoglu, Selim Selcuk Comoglu
BACKGROUND: Carpal tunnel syndrome (CTS) occurs as a result of compression of the median nerve at the wrist. The Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire is a selfadministered region-specific outcome instrument which measures symptom severity and functional status. OBJECTIVES: The aim of this study was to evaluate the clinical and electrophysiological relationship with QDASH scale in CTS. MATERIAL AND METHODS: The study included 99 females and 22 males in total out of 121 idiopathic CTS patients with the mean age of 47...
January 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Erek W Latzka, P Troy Henning, Adam M Pourcho
Carpal Tunnel Syndrome (CTS) is the most common entrapment neuropathy, resulting in 500,000 carpal tunnel release (CTR) surgeries and a total cost of over 2 billion dollars annually in the United States.1,2 Although initially performed via a large (3-5 cm), palmar incision, CTR techniques have continually evolved to reduce recovery times and post-operative pain, and improve cosmesis and clinical outcomes.2,3 More recently, multiple authors have reported excellent results following ultrasound-guided carpal tunnel release (USCTR) using a variety techniques, and one prospective randomized trial reported faster recovery following USCTR compared to traditional mini-open CTR...
March 5, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Troy Henning, Daniel Lueders, Kate Chang, Lynda Yang
The prevalence of carpal tunnel syndrome(CTS) in patients that suffer from post-polio syndrome occurs at a rate of 22%.[1] Irrespective of those with CTS, 74% of post-polio patients weight bear through their arms for ambulation or transfers.[1] As open carpal tunnel release is performed along the weight bearing region of the wrist, their functional independence may be altered while recovering. This case demonstrates that ultrasound guided carpal tunnel release(USCTR) was successfully performed in a patient with post-polio syndrome allowing him to immediately weight bear through his hands after the procedure so he could recover at home...
March 5, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Vanessa Baute, Vahakn S Keskinyan, Erica R Sweeney, Kayla D Bowden, Allison Gordon, Janet Hutchens, Michael S Cartwright
INTRODUCTION: Magnet therapy has been proposed as a treatment for neurologic conditions. This trial assessed the feasibility and efficacy of a magnet inserted into a wristband for carpal tunnel syndrome (CTS). METHODS: 22 patients with mild-to-moderate CTS were randomized to wear a high-dose or low-dose "sham" magnetic wristband for 6 weeks. The primary outcome was the symptom severity scale (SSS) of the Boston Carpal Tunnel Questionnaire. Secondary measures were nerve conduction studies (NCS), median nerve ultrasound, and compliance...
March 7, 2018: Muscle & Nerve
Gi-Young Park, Dong Rak Kwon, Jung Im Seok, Dong-Soon Park, Hee Kyung Cho
Background Carpal tunnel syndrome (CTS) is the most common peripheral compression neuropathy of the upper extremity. Recently, dynamic ultrasound (US) imaging has shown differences in median nerve mobility between the affected and unaffected sides in CTS. Purpose The present study was performed to compare the median nerve mobility between patients with CTS and healthy individuals, and to correlate median nerve mobility with the severity of CTS. Material and Methods A total of 101 patients (128 wrists) with CTS and 43 healthy individuals (70 wrists) were evaluated...
January 1, 2018: Acta Radiologica
Jacob A Martin, Christopher R Mayhew, Amanda J Morris, Angela M Bader, Mitchell H Tsai, Richard D Urman
Background: Time-driven activity-based costing (TDABC) is a methodology that calculates the costs of healthcare resources consumed as a patient moves along a care process. Limited data exist on the application of TDABC from the perspective of an anesthesia provider. We describe the use of TDABC, a bottom-up costing strategy and financial outcomes for three different medical-surgical procedures. Methods: In each case, a multi-disciplinary team created process maps describing the care delivery cycle for a patient encounter using the TDABC methodology...
April 2018: Journal of Clinical Medicine Research
Dong Yoon Park, Seok Kang, Jin Seok Jeong, Joon Shik Yoon
INTRODUCTION: The purpose of this study was to investigate the usefulness of the echogenicity (EI) ratio of the thenar to hypothenar muscle measured using ultrasonography in assessing the severity of carpal tunnel syndrome (CTS). METHODS: Fifty-nine hands of 30 patients electrodiagnostically confirmed as having CTS were classified into 3 subgroups (mild, moderate, and severe). The EI of the thenar and hypothenar muscles was measured with ultrasonography, and the EI ratio was calculated in the patients and 13 normal participants (26 hands)...
March 6, 2018: Muscle & Nerve
Kotaro Matsumoto, Jun Kikuchi, Yuko Kaneko, Hidekata Yasuoka, Kazuko Suzuki, Hirobumi Tokuyama, Kaori Kameyama, Kunihiro Yamaoka, Tsutomu Takeuchi
RATIONALE: Dialysis-related amyloidosis (DRA) can present rheumatic manifestations in patients on long-term hemodialysis. Typical articular symptoms with DRA involve carpal-tunnel syndrome, effusion in large joints, spondyloarthropathy, or cystic bone lesions, which are usually with non-inflammatory processes. PATIENT CONCERNS: A 64-year-old man on hemodialysis for >30 years was admitted because of intermittent fever, polyarthritis, and elevated serum C-reactive protein (CRP) level, which was continuous for 2 years...
January 2018: Medicine (Baltimore)
James H Calandruccio, Norfleet B Thompson
Carpal tunnel syndrome (CTS) is one of the most common musculoskeletal disorders of the upper extremity. Comorbidities associated with the development of CTS include diabetes and obesity. Although a high rate of repetitive hand/wrist motions is a risk factor, there is insufficient evidence to implicate computer use in the development of CTS. Initial treatment generally is nonoperative, with the strongest evidence supporting bracing/splinting. Strong evidence supports operative treatment, regardless of technique, as superior to nonoperative treatment...
April 2018: Orthopedic Clinics of North America
Adam E M Eltorai, Wesley M Durand, Jack M Haglin, Lee E Rubin, Arnold-Peter C Weiss, Alan H Daniels
Understanding trends in reimbursement is critical to the financial sustainability of orthopedic practices. Little research has examined physician fee trends over time for orthopedic procedures. This study evaluated trends in Medicare reimbursements for orthopedic surgical procedures. The Medicare Physician Fee Schedule was examined for Current Procedural Terminology code values for the most common orthopedic and nonorthopedic procedures between 2000 and 2016. Prices were adjusted for inflation to 2016-dollar values...
March 1, 2018: Orthopedics
Seher Ünver, Neriman Akyolcu
Context: Carpal tunnel syndrome (CTS) is one of the most common peripheral neuropathies, and there is no consensus on the preferred method of treatment. Aims: The aim of this study is to determine the effects of hand exercise performed with a ball on symptoms and to evaluate the results in hemodialysis (HD) patients with CTS. Settings and Design: This study was conducted in patients with HD who were treated in dialysis centers and state hospitals in Turkey between 2011 and 2012...
January 2018: Asian Journal of Neurosurgery
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