Background: Carpal tunnel syndrome (CTS) is the most common compressive neuropathy. Diabetes mellitus is the most common disease that predisposes the patients to CTS. Diabetic neuropathy is a progressive disease and diabetics nerve is more susceptible to compression at known sites of anatomic constrains such as in the carpal tunnel; clinical results of carpal tunnel release has been questioned not to be as good as non-diabetic patients. Objectives: This study was carried out to compare the clinical and electrodiagnostic outcomes of diabetic and non-diabetic carpal tunnel release (CTR) surgery. Patients and Methods: Twenty diabetic hands (14 patients) and 18 non-diabetic hands (14 patients) that underwent CTR between Octobers 2009 -2012 were evaluated. They were operated by one hand surgeon and were evaluated at least six months after the operation. Clinical symptoms as numbness, pain, paresthesia and nocturnal symptoms were evaluated. Electrodiagnostic results were evaluated pre-and post-operatively. Results: After surgical release, both groups showed significant improvements in clinical results, as 81.6% of patients had excellent and good outcomes, 18.4% had fair outcomes, and no one had poor outcome. Except for median sensory nerve conduction velocity (NCV) changes that had significant differences between diabetic and non-diabetic groups, other parameters had no significant differences between both groups. Furthermore, significant reverse correlation was found between the duration of CTS and the outcome. Conclusions: Clinical and electrodiagnostic results after CTR are approximately the same in patients with diabetes and without it. Diabetics with CTS as well as non-diabetic patients have satisfactory results after CTR surgery. Furthermore, the duration of CTS has a significant influence on the result of CTR; the shorter duration of diabetes, the better the result of CTR surgery.

Background: Fingertip injuries are among the most prevalent hand injuries. The fingertip has important sensory and functional role. When the size of fingertip skin defect is large, full thickness skin grafting is necessary. There are several donor sites for obtaining skin graft; however, there is no study concerning the best region of harvesting skin graft compatible with the fingertip. Objectives: This study was designed to compare the skin grafts harvested from wrist and groin for fingertip skin loss. Patients and Methods: A total of 72 patients in need of skin grafting were randomized to two group of 36 to receive skin graft harvested from the wrist or from the groin regions. The patients included 71 males and only one female patient who was in the wrist harvested group. All the patients were operated by one technique. The minimum follow-up period was 18 months. The grafted skin was evaluated clinically regarding two-point discrimination (TPD), light touch, ulcer, graft contracture, hair growth on the grafted skin, and color difference between the graft and recipient site, which was evaluated with photo analyzer in Photoshop software. Results: The grafted skins were compared between groups. Clinically, TPD and light touch were better (lower thresholds) in the wrist group (P < 0.05). Moreover, The amount of skin contracture, color difference between grafted skin and recipient site, and hair follicle counts were less in the wrist group (P < 0.001). In both groups, there were no ulcer and fissuring. Conclusions: For fingertip injures, full thickness skin grafts harvested from the wrist have significantly better cosmetic and functional results including better TPD and light touch, less hair follicles, less color difference, and less contracture.

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Background: Carpal tunnel syndrome (CTS) is the most common compressive neuropathy. Diabetes mellitus is the most common disease that predisposes the patients to CTS. Diabetic neuropathy is a progressive disease and diabetics nerve is more susceptible to compression at known sites of anatomic constrains such as in the carpal tunnel; clinical results of carpal tunnel release has been questioned not to be as good as non-diabetic patients. Objectives: This study was carried out to compare the clinical and electrodiagnostic outcomes of diabetic and non-diabetic carpal tunnel release (CTR) surgery. Patients and Methods: Twenty diabetic hands (14 patients) and 18 non-diabetic hands (14 patients) that underwent CTR between Octobers 2009-2012 were evaluated. They were operated by one hand surgeon and were evaluated at least six months after the operation. Clinical symptoms as numbness, pain, paresthesia and nocturnal symptoms were evaluated. Electrodiagnostic results were evaluated pre-and post-operatively. Results: After surgical release, both groups showed significant improvements in clinical results, as 81.6% of patients had excellent and good outcomes, 18.4% had fair outcomes, and no one had poor outcome. Except for median sensory nerve conduction velocity (NCV) changes that had significant differences between diabetic and non-diabetic groups, other parameters had no significant differences between both groups. Furthermore, significant reverse correlation was found between the duration of CTS and the outcome. Conclusions: Clinical and electrodiagnostic results after CTR are approximately the same in patients with diabetes and without it. Diabetics with CTS as well as non-diabetic patients have satisfactory results after CTR surgery. Furthermore, the duration of CTS has a significant influence on the result of CTR; the shorter duration of diabetes, the better the result of CTR surgery.