Improved Surgical Outcomes With Endoscopic Carpal Tunnel Release in Patients With Severe Median Neuropathy

Calotta, Nicholas A.; Lopez, Joseph; Deune, E. Gene

doi:10.1177/1558944716661995

Cited by 16 publications

(6 citation statements)

References 28 publications

(30 reference statements)

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“…Endoscopic techniques are attractive given that the previous studies have demonstrated no significant difference in outcomes between open and endoscopic approaches; endoscopic techniques provide visualization of the entire transverse carpal ligament without requiring the second incision in the palm, and minimally invasive/endoscopic approaches are increasingly desired by patients. 19,20 Badia et al 21 was the first to propose an endoscopic technique; however, their approach used 2 distinct incisions (an extensive FCR approach for fracture fixation and a separate small transverse approach for endoscopic neurolysis). Low and Cheah 9 published a technical note on the possibility of endoscopic carpal tunnel release using the Henry approach; however, the feasibility and results in a clinical setting were not assessed.…”

Section: Discussionmentioning

confidence: 99%

Surgical Technique for Concurrent Endoscopic Carpal Tunnel Release and Distal Radius Fracture Fixation Using the Flexor Carpi Radialis Approach: A Case Series

Bhashyam

Kao

2022

Journal of Hand Surgery Global Online

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Purpose: Multiple prior studies have assessed the results of open approaches for concurrent carpal tunnel release with distal radius fracture fixation; however, less is known regarding the feasibility of endoscopic techniques, especially in the setting of high-energy trauma. In this study, we assessed the feasibility and results of concurrent endoscopic carpal tunnel release and distal radius fracture fixation using the flexor carpi radialis approach after high-and low-energy trauma. Methods: We performed a retrospective, single-surgeon study of 17 consecutive adult patients (aged >18 years) who underwent open reduction internal fixation of an acute distal radius fracture with concurrent endoscopic carpal tunnel release at a level 1 trauma center between April 2017 and October 2020. Recovery from median nerve dysfunction was assessed from patient charts at routinely scheduled postoperative follow-up visits (at 2 weeks, 4 weeks, 6 weeks, and 12 weeks). Results: The transverse carpal ligament could be visualized and released in all patients. All patients had a return of light touch sensibility with or without intermittent paresthesia by 12 weeks after surgery (the median time from surgery to recovery was 19 days [range, 12e82 days]). There were no patient reports or clinical examination evidence of palmar cutaneous branch, recurrent motor branch, or the third common digital nerve injury. Time to recovery was significantly different in the setting of high-versus low-energy trauma (26 days vs 18 days, respectively; P ¼ .02). Conclusions: In this study, we demonstrated that concurrent endoscopic carpal tunnel release using the flexor carpi radialis approach for distal radius fracture fixation in the settings of high-and low-energy trauma is safe from major complications and effective at releasing the transverse carpal ligament. Type of study/level of evidence: Therapeutic IV.

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Section: Discussionmentioning

confidence: 99%

Surgical Technique for Concurrent Endoscopic Carpal Tunnel Release and Distal Radius Fracture Fixation Using the Flexor Carpi Radialis Approach: A Case Series

Bhashyam

Kao

2022

Journal of Hand Surgery Global Online

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“…The effectiveness of the surgical method utilized is also a risk factor. Some studies have found recurrence rates to be between 2.6-7% following endoscopic carpal tunnel surgery, which has lately become more popular [15,16]. The complaint of numbness was found to have continued for longer in cases who underwent endoscopic surgery [17].…”

Section: Discussionmentioning

confidence: 99%

Modified mini-incision surgery for carpal tunnel syndrome: Results of 131 interventions

Asan¹

2018

Ann Clin Anal Med

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Aim: The aim was the presentation of results from 131 interventions in which a quick and practical modified surgical approach was applied in carpal tunnel syndrome surgery. Material and Method: In total, 131 surgical interventions were made in 121 cases. 22 cases were male, 99 cases were female. Boston Carpal Tunnel Syndrome Questionnaire scores were obtained on the postoperative 12th-14th day and compared with the preoperative scores. All cases were performed with local anesthesia. In all cases, surgical equipment consisted of one no-15-blade, one automatic retractor, and one 45 cm prolene 3-0. Results:According to EMG results, 71 patients had severe, 49 patients had moderate, and 11 patients had moderate-mild carpal tunnel syndrome. The average time for the surgery was 7.2 minutes. During surgery, one automatic retractor was used, and manipulations that shorten the time of surgery and increase surgical safety have been described. The average incision length was 1.5-2 cm. Subcuticular skin suture was not performed. The stitches were removed on the 12th postoperative day. Seven cases presented wound site inflammation. Relapse in the latter course was not encountered in any case. Discussion: The method described as a modification of mini-incision surgery is thought to be reliable, comfortable, and cost-effective. Use of an automatic retractor considerably shortens surgical time and facilitates surgery. Not performing subcuticular suture reduces the probability of relapse. In cases with a high risk factor for infection, treatment of the wound site requires further care.

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“…Calotta et al 16 included 126 patients. 39 patients were managed with Endoscopic release carpal tunnel syndrome and 99 open methods.…”

Section: Akkurt Et Al Reported Both Endoscopic and Openmentioning

confidence: 99%

The outcome of carpal tunnel syndrome with modified mini-incision technique.

Kalhoro¹,

Hashim

Sattar

2021

Int. j. endorsing health sci. res.

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Background: Median nerve compression in hand at the level of transverse ligament leads to numbness and pain in the hands, which results in discomfort in daily routine work has a psychological impact. The objective of the present study was to evaluate the modified mini-incision at the transverse crease in carpal tunnel syndrome. Methodology: A prospective descriptive study was conducted at Neurospinal & cancer care Institute, Karachi, from January 2012 – February 2020. Patients who were diagnosed with clinical symptoms, positive Phalen and Tinel test and confirmed with EMG finding of carpal tunnel syndrome were included in the study. Patients were operated through modified mini-incision at the transverse crease. The outcome was recorded in the form of pain relief, healing time with restoration of daily life activity and scar adhesion on follow-up. Results: A total of 97 patients were included. The male to female ratio was 1:7.8. The mean age was 40 ± 19.5 years. The right hand was 72.2%, the left hand was 13.4%, and the bilateral was 14.4%. VAS score improved 2 grades in 96%, and pinch grip improved in 98% of patients in one month. Only 2% of patients had stiffness after surgery Conclusion: Minimal incision carpal tunnel release has shown positive outcome in median nerve compression, having limited skin incision, safe, feasible and minimizing the scar assist help in early return to work.

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Improved Surgical Outcomes With Endoscopic Carpal Tunnel Release in Patients With Severe Median Neuropathy

Abstract: ECTR is a safe and effective alternative to OCTR for patients with severe CTS.

Cited by 16 publications

References 28 publications

Surgical Technique for Concurrent Endoscopic Carpal Tunnel Release and Distal Radius Fracture Fixation Using the Flexor Carpi Radialis Approach: A Case Series

Surgical Technique for Concurrent Endoscopic Carpal Tunnel Release and Distal Radius Fracture Fixation Using the Flexor Carpi Radialis Approach: A Case Series

Modified mini-incision surgery for carpal tunnel syndrome: Results of 131 interventions

The outcome of carpal tunnel syndrome with modified mini-incision technique.

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