No advantage from splinting the wrist after open carpal tunnel release: A randomized study of 82 wrists

Finsen, Vilhjalmur; Andersen, Kim Francis; Russwurm, Harald

doi:10.3109/17453679908997810

Cited by 59 publications

(40 citation statements)

References 12 publications

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“…However, the current available body of literature is in favor of limiting prolonged immobilization after carpal tunnel release because it is of no advantage 3,7 or even detrimental due to delayed mobilization and physical therapy. 4 Therefore, we evaluated the potential beneficial effect of short-term splinting in ameliorating postoperative pain or hematoma formation.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous studies have compared different types of treatment strategies such as endoscopic carpal tunnel release, 19,20 steroid injection, 9 and various other surgical techniques 6,11,12 with the open approach in order to find the most effective way to treat this entity. However, few articles have compared postoperative treatment and rehabilitation, such as postoperative splinting, 3,4,7 postoperative physiotherapy, 8,18 and postoperative mobilization. 16 Postoperative discomfort, such as pain, and objective parameters, such as electrophysiological studies, are generally not considered in this context.…”

mentioning

confidence: 99%

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Postoperative splinting after open carpal tunnel release does not improve functional and neurological outcome

Huemer¹,

Köller²,

Pachinger³

et al. 2007

Muscle and Nerve

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Although surgical division of the transverse carpal ligament is the operative treatment of choice for carpal tunnel syndrome (CTS), controversy exists about the immediate postoperative treatment regimen. Splinting for up to 6 weeks after surgery is recommended by some investigators. We therefore evaluated effectiveness of splinting after open carpal tunnel surgery by a randomized, controlled trial. Fifty consecutive patients with clinically and electrophysiologically confirmed idiopathic CTS were assigned to open carpal tunnel release and randomized to receiving a light bandage (25 patients) or a bulky dressing with a volar splint (25 patients) for 2 days each. All patients were followed up at 3 months. Parameters retrieved were pain as measured using a visual analog scale, two-point discrimination, and grip strength, and nerve conduction studies. At follow-up, all patients reported definite improvement of symptoms, but there was no statistically significant difference between the two groups for any of our outcome measures. Thus, postoperative splinting after open carpal tunnel release does not yield any benefit to eventual outcome. In fact, it adds to the overall operating time and can safely be abandoned.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Postoperative splinting after open carpal tunnel release does not improve functional and neurological outcome

Huemer¹,

Köller²,

Pachinger³

et al. 2007

Muscle and Nerve

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show abstract

“…The use of rigid braces that immobilise the wrist for 2-3 weeks after the intervention is usually suggested [13], although two randomised studies did not evidence any significant difference in grip strength or in the number of patients who were considered as healed after 2-4 weeks [49,50]. Another randomised study concludes that, compared to no treatment, the use of a splint for 2 weeks after the intervention significantly delayed the return to work [51] (Table 8).…”

Section: Postoperative Treatmentmentioning

confidence: 99%

Diagnosis, treatment and follow-up of the carpal tunnel syndrome: a review

et al. 2010

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The carpal tunnel syndrome is a compressive neuropathy with high incidence rates, and its correct diagnosis, treatment and follow-up may lead to significant benefits in healthcare, social and economic terms. In this review, based on systematic review databases and guidelines, we summarise the appropriate indications for the diagnosis, treatment and follow-up, accompanied, whenever possible, by the levels of evidence and strength of recommendations.

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“…Finsen et al in 1999 studied the value of wrist splinting following open decompression in 82 wrists [21]. In this study, there were no clear inclusion and exclusion criteria.…”

Section: Resultsmentioning

confidence: 95%

Does wrist immobilization following open carpal tunnel release improve functional outcome? A literature review

Isaac

Okoro

Danial³

et al. 2010

Curr Rev Musculoskelet Med

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Carpal Tunnel Syndrome (CTS) is a compressive neuropathy of the median nerve in the carpal tunnel. It is the most common peripheral entrapment neuropathy. The surgical management includes dividing the flexor retinaculum to decompress the median nerve. Post-operative mobilization of the wrist is controversial. Some surgeons splint the wrist for 2–4 weeks whilst others encourage early mobilization. The literature has been inconclusive as to which method is most beneficial. The purpose of this study is to review the literature regarding the effectiveness of wrist immobilization following open carpal tunnel decompression. We reviewed all published clinical trials claiming to evaluate the mobility status following open carpal tunnel release. Studies not in the English language as well as those with small number of patients (n < 30) were excluded. There were five studies that fulfilled the eligibility criteria and were included in this review. We conclude that there is no beneficial effect from post-operative immobilization after open carpal tunnel decompression when compared to early mobilization.

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No advantage from splinting the wrist after open carpal tunnel release: A randomized study of 82 wrists

Cited by 59 publications

References 12 publications

Postoperative splinting after open carpal tunnel release does not improve functional and neurological outcome

Postoperative splinting after open carpal tunnel release does not improve functional and neurological outcome

Diagnosis, treatment and follow-up of the carpal tunnel syndrome: a review

Does wrist immobilization following open carpal tunnel release improve functional outcome? A literature review

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