Immediate and Durable Clinical Improvement in the Non-Operated Hand after Contralateral Surgery for Patients with Bilateral Carpal Tunnel Syndrome

Unno, Florence; Lucchina, Stefano; Bosson, Dominique; Fusetti, Cesare

doi:10.1007/s11552-014-9719-6

Cited by 20 publications

(7 citation statements)

References 39 publications

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“…Carpal tunnel syndrome (CTS) is the most common compressive entrapment neuropathy caused by the compression of the median nerve at a space around the wrist known as the carpal tunnel. The prevalence of CTS in the United Kingdom is 70-160 cases per 1,000 subjects [ 1 - 3 ]. Many risk factors have been correlated with the development of this compressive neuropathy.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Obesity in Carpal Tunnel Syndrome Patients: A Cross-Sectional Survey

Mansoor¹,

Siddiqui²,

Mateen³

et al. 2017

Cureus

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Carpal tunnel syndrome (CTS) is the most common compressive entrapment neuropathy caused by the compression of the median nerve at the wrist space known as the carpal tunnel. The epidemiologic factors related to CTS include genetic, medical, social, vocational, and demographic factors. The common symptoms experienced include pain, paresthesia, and numbness in the median nerve distribution. If left untreated, it can lead to irreversible median nerve damage, causing a loss of hand function. Body mass index (BMI) has been attributed as a risk factor for the development of CTS.We planned to determine the frequency of obesity among CTS patients in the neurophysiology department of a tertiary care center in Islamabad, Pakistan. The survey was designed as a cross-sectional descriptive study from March 2016 to August 2016 using a consecutive nonprobability sampling technique. A total of 112 patients with a mean age of 54 ± 5 years were included in the study. In the study population, 39 patients (35 percent) were males and 73 were females (65 percent). Based on BMI, 74 patients (66 percent) had a normal weight and 38 (34 percent) were obese. The frequency of obesity in our study was 34 percent, excluding the other comorbid conditions, which is quite high. Targeted therapy in those with CTS should also include weight reduction measures because obesity poses a cause-and-effect relationship for both the severity and the pathogenesis of CTS.

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Section: Introductionmentioning

confidence: 99%

Prevalence of Obesity in Carpal Tunnel Syndrome Patients: A Cross-Sectional Survey

Mansoor¹,

Siddiqui²,

Mateen³

et al. 2017

Cureus

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“…49,50 The results of surgery on NH are conflicting in literature. Unno et al 51 evaluated patients with bilateral CTS operating on only one hand and reported improved hand NH both immediately postoperatively and at follow-up for 6 months after surgery, regardless of the severity of NH impairment. 51 According to Agrawal and Southern, 52 the improvement of NH hand in bilateral CTS cases showed spontaneous recovery in 37% of cases after 6 months of follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Idiopathic Carpal Tunnel Syndrome: Clinical‐Functional Characterization and Efficacy of Two Combined Postoperative Physiotherapeutic Treatments

Georgeto

Andraus

Oliveira³

et al. 2023

Orthopaedic Surgery

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Objective: To evaluate the efficacy of combined association instrument myofascial mobilization (IASTM) and stretching in patients with idiopathic bilateral carpal tunnel syndrome (CTS) operated on one hand and to analyze the response of the operated (OH) and non-operated (NH) hand according to the sequence of therapies. Research on these parameters has not yet been found in the literature.Methods: Randomized controlled crossover study with 43 participants using the objective and subjective outcome variables. Patients were randomly assigned to two groups: starting with stretching followed by IASTM and starting with IASTM followed by stretching. Then patients underwent surgery on the hand with more severe involvement and physical therapy rehabilitation was started 30 days after for a period of 4 weeks. After the 1-week interval the participants who started with stretching were referred to IASTM and vice versa, following the same previous patterns. The outpatient reassessments took place at 3 to 6 months. Crossover ANOVA and effect sizes were used as analysis methods.Results: Time was the most significant outcome for all variables both during therapies and at 6-month follow-up. Regarding response to the combined therapies between OH and NH, there were differences for both OH and NH, with the greatest impact on NH for the palmar grip and VAS variables. The treatment sequences were significant for pain on the NH and mental SF-12, suggesting that starting with IASTM followed by stretching had a superior outcome for these outcomes. Conclusion:The combination of IASTM with stretching, used in the postoperative period of bilateral idiopathic CTS, proved to be supplementary, with significant results and large effect sizes for most of the outcomes assessed, both during the time of application of the therapies and in the 6-month follow-up for both hands, and may constitute a viable therapeutic alternative for this population.

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“…It is noteworthy that the published literature additionally reports that improvement of the contralateral hand was found in 74–84% of cases, in objective and subjective evaluations with stable beneficial effects at 180 days [ 27 ]. This report showed that gender, age, professional status, duration of preoperative symptoms, and electrophysiological severity were not predictive.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Keyhole Approach to Carpal Tunnel Syndrome under Ambulatory Strategy

Ramos-Zúñiga

García-Mercado

Segura-Durán

et al. 2017

Neurology Research International

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The carpal tunnel syndrome is one of the most common entrapment neuropathies found in humans. Currently, the gold standard is surgical treatment using different modalities. The minimally invasive strategy with high resolution capacity and less morbidity is still a challenge. Methods. Prospective nonrandomised clinical trial in which a minimally invasive microsurgical approach was used following the keyhole principle in 55 consecutive patients and 65 hands under local anesthesia and ambulatory strategy. They were evaluated with stringent inclusion criteria with the Levine severity and functional status scale and with a 2-year follow-up. Results. 90% showed immediate improvement dropping to grades 1-2 in all items of the scale referring to pain and numbness. 97% reported improvement, as of the first month, and 3% reported persistence of symptoms, although at a lesser degree and with no functional limitation. No incidents were identified during the procedure and 98% of patients were discharged within an hour after the surgical procedure. Conclusions. The microsurgical approach described following the keyhole principle is a treatment option that, under local anesthesia and ambulatory management, may represent an alternative strategy of an effective treatment reducing the morbidity. This trial is registered with Clinical Trials Protocol Identifier NCT03062722.

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Immediate and Durable Clinical Improvement in the Non-Operated Hand after Contralateral Surgery for Patients with Bilateral Carpal Tunnel Syndrome

Cited by 20 publications

References 39 publications

Prevalence of Obesity in Carpal Tunnel Syndrome Patients: A Cross-Sectional Survey

Prevalence of Obesity in Carpal Tunnel Syndrome Patients: A Cross-Sectional Survey

Bilateral Idiopathic Carpal Tunnel Syndrome: Clinical‐Functional Characterization and Efficacy of Two Combined Postoperative Physiotherapeutic Treatments

Efficacy of Keyhole Approach to Carpal Tunnel Syndrome under Ambulatory Strategy

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