Treatment of Carpal Tunnel Syndrome by Members of the American Association for Hand Surgery

Abstract

Background Carpal tunnel syndrome (CTS) is the most common compressive neuropathy affecting the upper extremity, yet evidence-based guidelines for its diagnosis and treatment are lacking. We set out to expose any potential discrepancies in CTS practice attitudes based on surgeon's academic background, residency training, clinical experience, and other factors. Methods This was an online survey-based study. Members of the American Association for Hand Surgery (AAHS) were sent an electronic mail request (n0817). The online questionnaire consisted of 12 questions that queried surgeons' approaches to the diagnosis as well as operative and non-operative management of carpal tunnel syndrome. Results One hundred twenty-three surgeons responded to the survey (15.1 %). The locations of surgical practices varied within the United States and beyond. Most respondents were either orthopedic or plastic surgeons. With respect to practice duration, 15.4 % had been in practice for 5 years or less, 30.9 % of the respondents had been in practice between 6 and 15 years, 30.9 % had been in practice between 16 and 25 years, and 26.8 % had been in practice for more than 25 years. The most notable interspecialty differences were related to the use of operative antibiotics and the surgical approach. Plastic surgeons were less likely to recommend antibiotic use during surgery and more likely to utilize an open extensile approach during surgical release. Younger surgeons were more likely to employ a mini-open approach for carpal tunnel release.Conclusions We conclude that background training and generational differences contribute to the varied approaches observed in the diagnosis and management of CTS.

Trends in Carpal Tunnel Surgery: An Online Survey of Members of the American Society for Surgery of the Hand

“…Additionally, Shin et al performed a 12-question online survey of 123 members of the American Association of Hand Surgery in 2012. 8 Forty-six percent of respondents used a mini-open incision, and 20% used an endoscopic technique. Sixty-five percent of respondents used local anesthesia with or without intravenous sedation.…”

The Effect of Moving Carpal Tunnel Releases Out of Hospitals on Reducing United States Health Care Charges

“…The data is from 2006 and practices may have changed over time, although a 2012 survey of AAHS members found a similar rate of straight local anesthesia, suggesting that the type of anesthesia used for CTR has not changed substantially. 20 Another limitation of this study was the use of charges as a proxy for costs. Charges do not reflect the cost of service delivery or payments to healthcare providers.…”

Comparison of Turkish and international trends in carpal tunnel surgery

“…An online survey was performed to ASSH members in 2012, and 46% of respondents preferred a mini-open incision, and 20% used an endoscopic technique. [6] In Munns' study, 50% of respondents preferred a mini-open incision, and 26% preferred an endoscopic technique. [3] There is an increasing trend towards mini-open and endoscopic techniques over the years by ASHH members.…”