Carpal tunnel syndrome: treatment with small transverse incision

Kaleff, Paulo Roland; Lima, Marcelo Senna Xavier de; Fernandes, Yvens Barbosa; Honorato, Danylo José Palma; Vargas, Antonio Augusto Roth; Honorato, Donizeti César

doi:10.1590/s0004-282x2010000100020

Cited by 10 publications

(5 citation statements)

References 29 publications

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“…In other similar local studies, Mansoor et al, 18 (2017) and Ehsan et al, 19 (2015) reported comparable female predominance with male to female ratio of 1:1.8 and 1:1.7 respectively. Similar female predominance has also been reported by Mardanpour et al, 16 (1:2.7) in India, Yagci et al, 20 (1:2.7) in Turkey and Kalef et al, 21 (1:2.3) in Brazil.…”

Section: Discussionsupporting

confidence: 86%

Function of Microscopic Carpal Tunnel Release in Cases Resistant to Conservative Therapy

Zeb¹,

Ullah²,

Shoaib³

et al. 2021

AJHMN

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Purpose: To determine the outcome of microscopic carpal tunnel release in patients with carpal tunnel syndrome who failed to respond to conservative treatment. Methodology: This descriptive case series was carried at Department of Neurosurgery, D.H.Q Hosptial Charsadda over 1 year from Jan 2019 to Dec 2020, indicate the sampling method used to select the study participants involving 94 patients; both men and women with ages in the range 30-70 years diagnosed of carpal tunnel syndrome who failed to respond to conservative treatment and were planned for surgical release. Microscopic CTS release was performed and outcomes were assessed in terms of improvement in VAS score for wrist pain, symptom severity score and function status scale 3 and 6 months after the surgery. Recurrence of symptoms was also noted. A written informed consent was obtained from every patient. Indicate the method of data collection and data analysis Findings: The mean age of the patients with carpal tunnel syndrome was 41.6±7.9 years. There was slight female predominance with male to female ratio of 1:2.1. History of diabetes was recorded in 29 (31.0%) patients while 34 (37.0%) patients were obese. Right hand was more frequently involved (53.0%) than the left hand (47.0%). The mean VAS score for wrist pain reduced from 7.9±1.2 at baseline to 1.8±0.7 3 months after the surgery (p- value<0.001). Similar improvements were also noted in symptom severity score (3.8±0.8 to 1.6±0.8; p- value<0.001) and function status scale (2.7±0.8 to 1.5±0.8; p-value<0.001) at the end of 3 months after the surgery. Recurrence was not observed in any patient at the end of 6 months follow-up. Recommendation: Microscopic carpal tunnel release was found to relieve patient’s symptoms and improve wrist function yet with minimal scarring and without recurrence which advocates its preferred use in future practice provided necessary surgical skills and hardware are available.

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Section: Discussionsupporting

confidence: 86%

Function of Microscopic Carpal Tunnel Release in Cases Resistant to Conservative Therapy

Zeb¹,

Ullah²,

Shoaib³

et al. 2021

AJHMN

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“…18 The treatment of CTS falls under two categories: conservative and surgical. Conservative treatmentwith medication, physiotherapy, splinting or local infi ltration can be initially 11…”

Section: Basnet Et Almentioning

confidence: 99%

Carpel ligament release for carpel tunnel syndrome (CTS) under local anesthesia: our experience with 277 cases

Basnet¹,

Bhattachan²,

Joshi³

et al. 2019

Nep J Neurosci

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Carpel tunnel syndrome (CTS) is one of the common neurological condition where median nerve is compressed by transverse carpel ligament at wrist. About 5% of general population suffer from this problem and most commonly occurred in young and middle-aged women. 30% of patients suffering from CTS can be managed by medications and physiotherapy and 70% may require surgical decompression at some stage. Surgical treatment is to decompress median nerve by releasing transverse carpel ligament either by open or endoscopic procedure. Both procedures have shown similar results. This is a retrospective study of 277 patients who underwent 349 decompressive surgical procedures under local anesthesia for CTS between May 2007 and April 2017 in our institute. Diagnosis was made from clinical signs and symptoms and confirmed by either NCV or EMG. All patients were operated in day care basis. Data were retrieved from OPD and OT records. Followed up duration ranged from 6 months to 10 years. There were 257 female and 20 male. 74% had unilateral and 26% had bilateral CTS. 93% CTS were idiopathic. 10% suffered postoperative complications.26% achieved immediate pain relief after decompression, 73% after three weeks and 98.5% after three months. Open decompression of CTS is a quick and simple OPD based surgical procedure.

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“…The mini-incision technique tries to combine the lower expense of the open surgeries with the shorter length of stay and reduced scarring of the endoscopic method; however, further studies are needed for its long-term assessment. 15,16 Given the socioeconomic impact (up to US$ 30,000 in the lifetime of each United States worker) of this pathology and the best results obtained with surgical treatment (superiority in functional improvement, in addition to early and longterm regression of the symptoms), 17 the present study tried to define the epidemiological aspects and cost estimates resulting from surgeries performed by the Brazilian Unified Health System (SUS, in the Portuguese acronym) for the treatment of CTS in Brazil between 2008 and 2016.…”

Section: Palavras-chavementioning

confidence: 99%

Epidemiology and Estimated Cost of Surgeries for Carpal Tunnel Syndrome Conducted by the Unified Health System in Brazil (2008–2016)

Magalhães

Fernandes²,

Alkmim³

et al. 2017

Arq Bras Neurocir

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Objective To define the epidemiological aspects and estimated costs of surgeries performed by the Brazilian Unified Health System (SUS, in the Portuguese acronym) for the treatment of carpal tunnel syndrome (CTS) in Brazil between 2008 and 2016. Materials and Methods Documentary study, with data from the Informatics Department of the SUS (DATASUS, in the Portuguese acronym), about the absolute number and incidence of admissions, the total and mean length of stay (in days), the total expenses, and the hospital and professional services expenses in the surgical treatment of CTS. Results During the period studied, there were 82,123 hospitalizations for surgery, with a 62% increase from 2008 to 2015, accompanied by an increase in the values of professional services. The incidence and the absolute number of procedures were higher in the South and Southeast regions. The North region presented the lowest expenses, absolute number, and incidence of admissions, as well as the longer mean length of stay. The mean length of stay decreased from 1.2 days in 2008 to 0.7 day in 2016. The expenses totaled BRL 29,463,148.80 during the period studied. After 2011, professional services became the largest portion of the total expenses. Hospital expenses corresponded to 52.49% of the expenditure in 2008, and to 36.24% in 2015, while professional expenses received the largest investment compared with the total amount expended in 2012. Conclusion The present study was not consistent with the international literature regarding epidemiological data and cost estimates. Brazil presented a disparity between absolute numbers and annual incidence of admissions and length of stay. Future researches can assess variables that have influenced these results, as well as contribute to public interventions aimed at the improvement of health care.

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Carpal tunnel syndrome: treatment with small transverse incision

Cited by 10 publications

References 29 publications

Function of Microscopic Carpal Tunnel Release in Cases Resistant to Conservative Therapy

Function of Microscopic Carpal Tunnel Release in Cases Resistant to Conservative Therapy

Carpel ligament release for carpel tunnel syndrome (CTS) under local anesthesia: our experience with 277 cases

Epidemiology and Estimated Cost of Surgeries for Carpal Tunnel Syndrome Conducted by the Unified Health System in Brazil (2008–2016)

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