Factors that determine reexploration treatment of carpal tunnel syndrome

O’Malley, Martin J.; Evanoff, Marguerite; Terrono, Andrew L.; Millender, Lewis H.

doi:10.1016/0363-5023(92)90307-b

Cited by 65 publications

(43 citation statements)

References 5 publications

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“…15 Extrapolating from our results, the use of collagen nerve conduits may also be useful in the setting of chronic nerve compression syndromes where increased interfascicular tissue may be found. 5,24,25 This study demonstrated decreased amounts of connective tissue formation with the use of a collagen nerve conduit during primary repair of peripheral nerve transections in a rat sciatic nerve model, which may or may not be of functional benefit and deserves further investigation.…”

Section: Discussionmentioning

confidence: 96%

Collagen nerve protector in rat sciatic nerve repair: A morphometric and histological analysis

et al. 2010

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Peripheral nerve repair is often complicated by fibroblastic scar formation, nerve dysfunction, and traumatic neuroma formation. Use of bio-absorbable protective wraps may improve outcomes of these repairs. This study histologically compared the incidence of neuroma formation, connective tissue proliferation, and axonal regrowth in transected rat sciatic nerves repaired with and without tubular collagen nerve sleeves. Twenty Sprague-Dawley rats underwent unilateral sharp sciatic nerve transection and microscopic nerve repair with four epineural sutures and were randomly treated with or without an encircling collagen nerve sleeve. Normal nerves from the contralateral sciatic nerve were also examined. At sacrifice three months later, the nerves were evaluated for traumatic neuroma formation, perineural scar formation, and morphometric analysis. Histological examination of normal and repaired nerves by a neuropathologist demonstrated healing, minimal Wallerian degeneration and no traumatic neuroma formation. Distal section analysis (nine nonwrapped, 10 wrapped), revealed no significant differences in total fascicular area, myelinated fibers per nerve, fiber density, myelin area per nerve, myelinated fiber diameter, axon diameter, myelin thickness, or G-ratio. Significantly greater (P = 0.005) inner epineural connective tissue formation was observed in nonwrapped nerves (0.62 mm(2) +/- 0.2) versus wrapped nerves (0.35 mm(2) +/- 0.16). The ratio of connective tissue to fascicular area was larger in nonwrapped (1.08 +/- 0.26) versus wrapped nerves (0.63 +/- 0.22) (P < 0.001). This study demonstrated decreased inner epineural connective tissue formation with use of a collagen nerve wrap during primary repair of peripheral nerve transection in a rat sciatic nerve model.

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Section: Discussionmentioning

confidence: 96%

Collagen nerve protector in rat sciatic nerve repair: A morphometric and histological analysis

et al. 2010

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“…Stang et al similarly noted that patients with recurrent CTS had better outcomes following revision surgery (36). Incomplete release of the flexor retinaculum has also been associated with improved outcomes (36,37), although this study and Cobb et al failed to find this association (38). Other factors predictive of worse prognosis following revision CTR include ulnar nerve symptoms (38), symptoms exacerbated by activity (37), absence of nocturnal symptoms (37), a positive Phalen test (37), worker's compensation (38), normal electrodiagnostic testing (38), and nerve injury (2,36).…”

Section: Discussionmentioning

confidence: 79%

Revision Carpal Tunnel Surgery: A 10-Year Review of Intraoperative Findings and Outcomes

Davidge¹,

Zieske²,

Ebersole³

et al. 2013

The Journal of Hand Surgery

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“…10,11 The success rate of revision CTR is much lower than the results of primary CTR, with failure rates reported as high as 40%. 9,12,13 In addition, patients undergoing revision CTR may have residual symptoms in 33% to 82% of cases. 4,9,14,15 In our study, 54% of wrists had complete resolution of preoperative symptoms, 29% had improvement but still some residual symptoms, and 18% had no improvement from revision CTR.…”

Section: Discussionmentioning

confidence: 98%

“…The use of an injection as a supplement to aid in diagnosis of recurrent or persistent CTS has been described, but its importance has not been evaluated. 3,9 The goal of this study was to evaluate whether relief from corticosteroid injection alone or in combination with other preoperative tests was a predictor of success after revision CTR.…”

mentioning

confidence: 99%