Prospective review of 278 endoscopic carpal tunnel releases using the modified chow technique

Nagle, Daniel J.; Harris, Gerald D.; Foley, Marijoy

doi:10.1016/s0749-8063(05)80108-2

Cited by 43 publications

(18 citation statements)

References 12 publications

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“…The efficacy of CTS surgery has been demonstrated repeatedly in prospective clinical studies [Feuerstein et al, 1999;Gerritsen et al, 2001Gerritsen et al, , 2002, and in two population-based studies [DeStefano et al, 1997;Katz et al, 1998a]. However, a number of studies have found that symptom and functional outcomes after CTS surgery are less favorable when a workers' compensation claim is involved, particularly a contested claim, compared to when no claim is involved [Chow, 1993;Nathan et al, 1993;Palmer et al, 1993;Kerr et al, 1994;Nagle et al, 1994;Roth et al, 1994;Strasberg et al, 1994;Higgs et al, 1995;Nancollas et al, 1995;Shapiro, 1995;Strickland et al, 1996;Katz et al, 1998a,b;Olney et al, 1999;Straub, 1999]. Given that surgery is used commonly for work-related CTS, it should be a high priority to characterize the factors related to work, health care delivery, or the workers' compensation process that may reduce the efficacy of surgery, and to develop treatment or case management strategies that would improve outcomes after surgery.…”

Section: Discussionmentioning

confidence: 99%

Work-related carpal tunnel syndrome in Washington State workers' compensation: Temporal trends, clinical practices, and disability

et al. 2005

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Section: Discussionmentioning

confidence: 99%

Work-related carpal tunnel syndrome in Washington State workers' compensation: Temporal trends, clinical practices, and disability

et al. 2005

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“…Controlled trials have demonstrated that surgery is significantly better than splinting for symptom relief, when symptoms are moderate or severe [Verdugo et al, 2008]. However, clinical outcomes after CTS surgery have often been reported to be less favorable when a workers' compensation claim is involved [Chow, 1993;Nathan et al, 1993;Palmer et al, 1993;Kerr et al, 1994;Nagle et al, 1994;Roth et al, 1994;Strasberg et al, 1994;Higgs et al, 1995;Nancollas et al, 1995;Shapiro, 1995;Strickland et al, 1996;Katz et al, 1998aKatz et al, ,b, 2005Olney et al, 1999;Straub, 1999]. However, individuals with workers' compensation claims commonly represented small fractions of these study samples, and it is conceivable that differences in patient selection, clinical severity, or other patient-or employment-related variables between cases with different modes of coverage could at least partially account for coverage-associated differences in treatment outcomes.…”

Section: Introductionmentioning

confidence: 99%

Work‐related carpal tunnel syndrome in Washington State workers' compensation: Utilization of surgery and the duration of lost work

Daniell

Fulton‐Kehoe

Franklin

2009

American J Industrial Med

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There is a need to scrutinize the role of surgery and physical-rehabilitation medicine modalities in the management of CTS covered by workers' compensation. The findings suggest disability can be minimized by establishing the CTS diagnosis as early as possible and, if surgery is appropriate, conducting surgery without substantial delay and maximizing post-operative efforts to facilitate return to work. Use of surgery >6 months after filing should be considered with great caution.

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“…Ninety-seven per cent of our short incision OHIP patients (171 of 177 hands) resumed ADL within 28 days. Reported ECTR results range from 78.3% to 100% within 28 days (7,8,14), a mean of 10.8 to 22.3 days (7,9,10,14,15) or a median of 13 to 16.5 days (12,14). Seventy-eight per cent of our short incision WC population (32 of 41 hands) resumed ADL within the 28-day period.…”

Section: Resultsmentioning

confidence: 87%

“…When a comparison was made by type of insurance reimbursement, patients who received WC required longer to recuperate and were more likely to require therapy than those who did not (7,9,10,(12)(13)(14)(15)(16)(17). Ninety-seven per cent of our short incision OHIP patients (171 of 177 hands) resumed ADL within 28 days.…”

Section: Resultsmentioning

confidence: 93%

“…Seventy-eight per cent of our short incision WC population (32 of 41 hands) resumed ADL within the 28-day period. Other studies reported a range of 33% to 63% within 28 days (7,8,14), a mean of 29.2 to 57.6 days (7,9,10,14,15) or a median of 57 to 71 days (12,14). The above studies were conducted in the United States, where many authors suspect that secondary gain is a factor in the recovery of WC patients (12,13,16,17).…”

Section: Resultsmentioning

confidence: 96%

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Open carpal tunnel release: Comparison of a long versus short incision

Kruger¹,

Rebot²

1998

CAN J PLAST SURG

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A review of our patients who had been treated with open carpal tunnel release (OCTR) undertaken in 1991 revealed that 78% had an uneventful course of recovery, resuming full function within two to four weeks, and that 25% required out-patient rehabilitation due to the persistence and magnitude of their symptoms three to four weeks postoperatively. Resumption of activities of daily living (ADL) was delayed by weakness, peri-incisional tenderness, restricted range of movement and swelling.In an effort to decrease postoperative morbidity and shorten recovery time, our surgical protocol was re-examined. Decreased postoperative discomfort and shorter recovery A total of 225 adults with carpal tunnel release of 313 wrists were studied to compare the outcome of a long (at least 3.5 cm) with that of a short (2.0 cm or less) incision technique. The two groups were compared for postoperative complaints, length of time until full function was regained, rate of referral to rehabilitation and the effect of Workers' Compensation status. The surgical technique and rehabilitation protocol are described. The number and severity of postoperative complaints were significantly reduced in the short incision group. In the non-Workers' Compensation group, 96% of short incision patients resumed full function within 28 days. This finding compares favourably with published results for endoscopic release, and is superior to results obtained with the long incision. Workers' Compensation patients required longer to recuperate, with 78% regaining full function within 28 days. Of those with Workers' Compensation, 47% of the long incision group and 27% of the short incision group required out-patient therapy. For the non-Workers' Compensation group, this percentage decreased to 21% of those with the long incision and 3% with the short incision. A history of vocational or avocational repetitive motion patterns was the most common indicator for therapy and accounted for 67% of rehabilitation referrals. Key Words: Adult, Carpal tunnel release, Median nerve, Occupational therapy, Physical therapy, Treatment outcomeDégagement ouvert du canal carpien : comparaison d'une incision longue versus courte RÉSUMÉ : En tout, 225 adultes ayant subi un dégagement du canal carpien, totalisant 313 poignets, ont été étudiés afin de comparer les résultats d'une technique d'incision longue (au moins 3,5 cm) versus courte (2,0 cm ou moins). Les deux groupes ont été comparés au chapitre des plaintes postopératoires, du temps de retour à un fonctionnement normal, du taux de demandes auprès des programmes de réadaptation et de l'effet sur la compensation par la CSST. La technique chirurgicale et le protocole de réadaptation sont décrits. Le nombre et la gravité des problèmes postopératoires ont été significativement moindres dans le groupe ayant subi l'incision courte. Pour le groupe non inscrit à la CSST, 96 % des patients ayant subi une incision courte ont retrouvé un fonctionnement normal en 28 jours. Ces résultats se comparent favorablement aux résultats publiés a...

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Prospective review of 278 endoscopic carpal tunnel releases using the modified chow technique

Cited by 43 publications

References 12 publications

Work-related carpal tunnel syndrome in Washington State workers' compensation: Temporal trends, clinical practices, and disability

Work-related carpal tunnel syndrome in Washington State workers' compensation: Temporal trends, clinical practices, and disability

Work‐related carpal tunnel syndrome in Washington State workers' compensation: Utilization of surgery and the duration of lost work

Open carpal tunnel release: Comparison of a long versus short incision

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