Decreased Rate of Complications in Carpal Tunnel Release with Hand Fellowship Training

Mathen, Santosh J.; Nosrati, Naveed; Merrell, Gregory A.

doi:10.1055/s-0037-1618913

Cited by 12 publications

(7 citation statements)

References 15 publications

(13 reference statements)

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“…Although carpal tunnel surgery is considered to be one of the safest procedures performed by surgeons, there is still a minute risk that the MN may be lacerated or completely cut during the operation [13]. This is one of the most serious complications.…”

Section: Introductionmentioning

confidence: 99%

The anatomical landmarks effective in the localisation of the median nerve during orthopaedic procedures

et al. 2021

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Section: Introductionmentioning

confidence: 99%

The anatomical landmarks effective in the localisation of the median nerve during orthopaedic procedures

et al. 2021

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“…The study from Mardanpour et al demonstrated its satisfactory functional outcomes and a low complication rate 27 . Other studies concerning open carpal tunnel release surgery showed lower infection rates 28‐30 …”

Section: Discussionmentioning

confidence: 93%

“… 27 Other studies concerning open carpal tunnel release surgery showed lower infection rates. 28 , 29 , 30 …”

Section: Discussionmentioning

confidence: 99%

Seasonal impact on surgical site infections and wound healing disturbance in carpal tunnel surgery: A retrospective cohort study

Froschauer

Raher

Holzbauer

et al. 2021

International Wound Journal

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Carpal tunnel syndrome is the most common entrapment syndrome of a peripheral nerve. The gold standard treatment is open carpal tunnel release which has a high success rate, a low complication rate, and predictable postoperative results. However, it has not been analysed yet if there is a seasonal influence on complications for carpal tunnel release, a highly elective procedure. In this retrospective study, we determine whether there is a seasonal impact on surgical site infections (SSI) and wound healing disorders (WHD) in primary carpal tunnel syndrome surgery. Between 2014 and 2018, we have assessed 1385 patients (65% female, 35% male) at a mean age of 61.9 (SD 15.3) years, which underwent open carpal tunnel release because of primary carpal tunnel syndrome. The seasonal data such as the warm season (defined as the period from 1st of June until 15th of September), the average daily and monthly temperature, and the average relative humidity were analysed. Patient demographics were examined including body mass index, alcohol and nicotine abuse, the use of anticoagulants and antiplatelet drugs as well as comorbidities. These data were correlated regarding their influence to the rate of surgical site infections and wound healing disorders in our study collective. A postoperative SSI rate of 2.4% and a WHD rate of 7% were detected. Our data confirms the warm season, the average monthly temperature, and male sex as risk factors for increasing rates of WHDs. Serious SSIs with subsequent revision surgery could be correlated with higher age and higher relative humidity. However there is no seasonal impact on SSIs. We therefore advise considering the timing of this elective surgery with scheduling older male patients preferably during the cold season to prevent postoperative WHDs.

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“…A recent study of almost 30,000 carpal tunnel releases showed that fellowship training among ABOS candidates improved outcomes and decreased complication rates for open and endoscopic carpal tunnel release. 15 Another study of ABOS candidates performing distal clavicle excision from 2004 to 2013 showed a lower reported complication rate for sports-medicine fellowship-trained candidates compared to all other candidates. 16 When specifically evaluating operative fixation of clavicle fractures, Leroux et al found that fewer years in practice was associated with a small but significant risk of developing an infection.…”

Section: Discussionmentioning

confidence: 99%

Trauma fellowship impact on trends and complications of operatively treated clavicle fractures in recently trained orthopedic surgeons

Gombera

Morris

Elkousy

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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The purpose of this study was to evaluate whether fellowship training affected trends and complications of operative clavicle fracture treatment in newly trained orthopedic surgeons. Methods: The American Board of Orthopedic Surgery (ABOS) database was utilized to identify cases of open treatment of clavicle fractures submitted by ABOS Part-II Board Certification candidates. From 2005 to 2017, 3148 candidates performed at least one open clavicle fracture treatment. Overall, 6919 cases were included; 3516 of these had over 6 weeks of follow-up. Candidates were divided by fellowship type into 5 groups: Trauma, Sports Medicine, Hand and Upper Extremity or Shoulder, multiple, and other or no fellowship(s). Group differences were analyzed with ANOVA and Bonferroni post hoc analysis.Complications, reoperations, nonunion rates, and readmissions between groups were evaluated with Chi-squared test and logistic regression analyses. Results: Case volume during the study period was significantly higher after 2007. Trauma candidates performed significantly more operations for clavicle fracture per candidate while candidates with other or no fellowship(s) performed significantly fewer operations per candidate. Patients treated by Trauma candidates were significantly older, had significantly fewer early surgical complications and significantly more early medical complications. Nonunion rates were not significantly different between groups. Conclusion: Candidates treated clavicle fractures surgically more often in 2007 and beyond. Trauma candidates treated older patients, had fewer early surgical complications, and had more medical complications. Reoperation, readmission and nonunion rates were not significantly different between groups.

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Decreased Rate of Complications in Carpal Tunnel Release with Hand Fellowship Training

Abstract: Surgeons undergoing additional hand fellowship training may show improved outcomes in the surgical treatment of carpal tunnel syndrome. However, no effect was seen on nerve injury or recurrence of symptoms.

Cited by 12 publications

References 15 publications

The anatomical landmarks effective in the localisation of the median nerve during orthopaedic procedures

The anatomical landmarks effective in the localisation of the median nerve during orthopaedic procedures

Seasonal impact on surgical site infections and wound healing disturbance in carpal tunnel surgery: A retrospective cohort study

Trauma fellowship impact on trends and complications of operatively treated clavicle fractures in recently trained orthopedic surgeons

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