Background: The authors conducted a prospective, multi-centre study to assess the impact of carpal tunnel release (CTR) on Two-Point Discrimination (2-PD), Quick Disabilities of Arm, Shoulder and Hand Score (Q-DASH), and Distal Motor Latency (DL). The primary aim was to determine the change in outcome measurements (2-PD, Q-DASH and DL) preoperatively and postoperatively at 6 months and 1 year. The secondary aims of the study were to determine whether the postoperative outcomes were different at the 6-month and 1-year follow-up and if there was difference in outcomes based on the preoperative severity of carpal tunnel syndrome (CTS). Methods: A total of 205 hands in 171 patients underwent CTR at five hospitals over a 2-year period. A total of 110 hands in 94 patients were followed-up and analysed. The 2-PD, Q-DASH and DL were measured for all patients preoperatively and at 6 months and 1 year postoperatively. Patients were divided into two groups ‘mild’ and ‘severe’ based on pre-operative DL score (mild ≤ 8.1 msec). The change in preoperative and postoperative 2-PD, Q-DASH and DL values were compared. The change in pre-operative and post-operative 2-PD and Q-DASH values were also compared between the ‘mild’ and ‘severe’ groups. Results: The 2-PD, Q-DASH and DL showed significant improvement at 6-month and 1-year follow-ups compared to pre-operative values. However, there were no significant differences in all three parameters between the 6-month and 1-year measurements. There was significant improvement in preoperative and postoperative 2-PD and Q-DASH scores between the mild and severe groups. Conclusions: CTR is an effective treatment for patients with CTS with significant improvement in all three outcome parameters (2-PD, Q-DASH and DL). The improvement in outcome plateaus at 6 months and additional follow-up may not be useful. Level of Evidence: Level II (Therapeutic)
Background: Subcutaneous spontaneous ruptures of the finger extensor tendons at the wrist frequently occur. This study aims to evaluate the outcomes of patients with extensor tendon ruptures treated by our operative methods and postoperative early active mobilization. Methods: A total of 38 patients with 68 extensor tendon ruptures were included in this study. In the reconstruction of extensor tendon ruptures, tendon transfers (extensor indicis proprius (EIP) tendon transfer and/or interlacing end-to-side suture) and/or free tendon bridge graftings were performed. Immediately after operation in all patients, early active mobilization began by wearing a specially designed bandage or splint. Results: There was no reoccurrence of re-rupture of a tendon post surgery. A patient satisfaction survey revealed that 29 patients rated their results as “excellent” and 9 were “good.” Postoperatively, the active range of motion of the finger metacarpophalangeal (MP) joint averaged +3[Formula: see text](range: −14[Formula: see text]+20[Formula: see text]) in extension and 69[Formula: see text](range: 60–80[Formula: see text]) in flexion. Conclusions: We treated finger extensor tendon ruptures by tendon transfer (EIP tendon transfer to the ruptured extensor tendon and/or interlacing end-to-side suture) and/or bridge tendon grafting. We employed early active mobilization with patients wearing a specially designed bandage or splint immediately after reconstructing surgery. There was no case with re-rupture postoperatively. Our operative techniques and postoperative physiotherapy as early active mobilization in this study led to excellent results after finger extensor tendon ruptures.
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