Clinical outcomes of carpal tunnel release in patients 65 and older

Weber, Robert A.; Rude, Malcolm J.

doi:10.1016/j.jhsa.2004.08.005

Cited by 44 publications

(21 citation statements)

References 15 publications

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“…The average age at surgery was above 44 in both males and females; however, the females outnumbered males by more than 50%. This was in agreement with the previously published studies in the literature (32). Repetitive wrist motion was implicated in the pathogenesis of CTS (26).…”

Section: Discussionsupporting

confidence: 93%

Elevated basal cytosolic calcium of endothelial cells influences the post-surgical outcome in diabetic CTS

et al. 2016

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Background: Type 2 diabetes mellitus (T2DM)-induced neuropathy and ischemia-reperfusion post-surgery prolong carpal tunnel syndrome (CTS) pathology, but the effect of T2DM on the prognostic outcome of carpal tunnel (CT) release surgery needs to be investigated. Materials and methods: A total of 64 individuals with CTS underwent CT release surgery. HbA1c levels identified their diabetic status. The individual prognostic outcomes were measured by nerve conduction velocity (NCV), amplitude, and latency. Measurement of [Ca 2+ ] c and reactive oxygen species (ROS) from isolated endothelial cells (ECs) revealed the oxidative burden of the normal and diabetic CTS phenotypes. Results: CTS individuals with HbA1c > 7 showed decreased NCV (≈22 m/s) and amplitude (≈4.2 mV) with increased latency (≈6 ms), compared to groups with HbA1c ≤ 7. Further to CT release surgery, the reversal of the nerve conduction to normalcy was greatly influenced by the diabetic profile of the individuals. Our results showed elevated basal [Ca 2+ ] c and corresponding high cytosolic ROS in the ECs isolated from individuals with HbA1c > 7 compared to the diabetic and healthy control groups. Conclusion: The individuals with diabetic index showed suboptimal neuronal performance pre-and post-CT release surgery. Oxidative stress mediated by high [Ca 2+ ] c and ROS of ECs dissipates to adjoining cells worsening the pathology of the untreated CTS.

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Section: Discussionsupporting

confidence: 93%

Elevated basal cytosolic calcium of endothelial cells influences the post-surgical outcome in diabetic CTS

et al. 2016

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“…Correlation method, effect size, and t-test comparing preoperative and postoperative scores are among the other methods used to assess MHQ responsiveness. 13,18,21 In this study, the pain domain of the MHQ was much more responsive (SRM ϭ 1.3) to change than the other domains. Function, activities of daily living (ADL), work, aesthetics, and satisfaction all had a rather similar responsiveness (SRM ϭ 0.78 -0.83), although some are considered moderate and some large due to the Cohen's categorization.…”

Section: Discussionmentioning

confidence: 52%

“…However, significant improvement in the aesthetics domain has been demonstrated after carpal tunnel decompression (p ϭ .001). 18 The authors' reasoning is that the patients have improved self-image secondary to better function following carpal tunnel release and their perception of their hand aesthetics is therefore improved. 18…”

Section: Comparison Of Preoperative and Postoperative Scorementioning

confidence: 99%

Comparative Responsiveness of the Michigan Hand Outcomes Questionnaire and the Carpal Tunnel Questionnaire After Carpal Tunnel Release

Chatterjee

Price

2009

The Journal of Hand Surgery

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“…32 However, long-term results in patients older than 65 years are equivalent. 33 Similarly, the long-term results of surgery for ulnar neuropathy at the elbow are equivalent in older patients. 30 However, there has not been adequate investigation into early neural recovery in this older cohort.…”

Section: Discussionmentioning

confidence: 99%

Trend of Recovery after Simple Decompression for Treatment of Ulnar Neuropathy at the Elbow

Giladi

Gaston

Haase³

et al. 2013

Plastic and Reconstructive Surgery

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Background Although numerous studies have investigated long-term outcomes after surgical treatment of ulnar neuropathy at the elbow with simple decompression, no study has evaluated the trend of postoperative recovery. The authors assessed timing of recovery after simple decompression for ulnar neuropathy at the elbow. Methods The five-center Surgery of the Ulnar Nerve Study Group prospectively recruited 58 consecutive subjects with ulnar neuropathy at the elbow and treated them with simple decompression. Patients were evaluated preoperatively and at 6 weeks, 3 months, 6 months, and 1 year postoperatively. Patient-rated outcomes questionnaires included the Michigan Hand Questionnaire; the Disabilities of the Arm, Shoulder and Hand questionnaire; and the Carpal Tunnel Questionnaire. Functional tests used were grip strength, key pinch strength, two-point discrimination, and Semmes-Weinstein monofilament testing. Postoperative improvement was assessed at each time point to establish the trend of recovery in reaching a plateau. Results Significant patient-reported symptomatic and functional recovery occurred over the first 6 weeks postoperatively as represented by improvements in questionnaire scores. Symptomatic recovery occurred earlier than functional recovery as measured by sensory and strength testing and the work domain of the Michigan Hand Questionnaire. Improvement in patient-reported outcomes continued and reached a plateau at 3 months, whereas measured strength and sensory recovery continued over 12 months. Conclusion The greatest clinical improvement after simple decompression for ulnar neuropathy at the elbow, according to questionnaire scores, occurs in the first 6 weeks postoperatively and reaches a plateau by 3 months.

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Clinical outcomes of carpal tunnel release in patients 65 and older

Cited by 44 publications

References 15 publications

Elevated basal cytosolic calcium of endothelial cells influences the post-surgical outcome in diabetic CTS

Elevated basal cytosolic calcium of endothelial cells influences the post-surgical outcome in diabetic CTS

Comparative Responsiveness of the Michigan Hand Outcomes Questionnaire and the Carpal Tunnel Questionnaire After Carpal Tunnel Release

Trend of Recovery after Simple Decompression for Treatment of Ulnar Neuropathy at the Elbow

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