Staged versus Simultaneous Bilateral Endoscopic Carpal Tunnel Release: An Outcome Study

Nesbitt, Kristin S.; Innis, Peter C.; Dubin, Norman H.; Wilgis, E.F. Shaw

doi:10.1097/01.prs.0000221073.99662.39

Cited by 16 publications

(21 citation statements)

References 12 publications

(13 reference statements)

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“…Bilateral simultaneous surgery is appealing as it could substantially decrease the cost to patients and their employers in terms of wages and productivity lost [6]. From the financial perspective, it was previously estimated that by performing the operations simultaneously instead of in stages, an amount of $682 could be saved per patient [2].…”

Section: Discussionmentioning

confidence: 99%

“…In the previously reported studies of endoscopic bilateral carpal tunnel release, the type of anaesthesia varied and mainly included local anaesthesia, local anaesthesia with sedation, regional blocks, and general anaesthesia [6,10]. The concerns that endoscopic carpal tunnel surgery is more technically demanding, requires a longer learning curve and may be associated with prolonged tourniquet time and higher complication rate have increased surgeons' [11].…”

Section: Discussionmentioning

confidence: 99%

“…These benefits are more evident in patients that routinely use both hands in their job, such as heavy labourers, and have expectations for a shorter postoperative period of disability and an earlier return to work. Nesbitt et al [6] compared outcomes of bilateral simultaneous endoscopic carpal tunnel release to staged release. Seventy-one patients were evaluated preoperatively and at six months postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…Carpal tunnel syndrome occurs bilaterally in 22 to 87 % of cases and may severely affect hand function and work performance [6]. In this case, simultaneous or staged bilateral carpal tunnel release is required when non-operative treatment does not provide satisfactory relief from symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…In this case, simultaneous or staged bilateral carpal tunnel release is required when non-operative treatment does not provide satisfactory relief from symptoms. Simultaneous endoscopic release of transverse carpal ligament may minimise the total disability time and the overall cost in terms of time off work as well as treatment and rehabilitation expenses [6]. On the other hand, opponents of the one-stage bilateral approach have expressed concerns about patients' ability to perform the postoperative activities of daily living and personal hygiene effectively [2,7].…”

Section: Introductionmentioning

confidence: 99%

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One portal simultaneous bilateral endoscopic carpal tunnel release under local anaesthesia. Do the results justify the effort?

Chalidis

Dimitriou

2013

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to evaluate whether simultaneous bilateral endoscopic carpal tunnel release could be effectively and safely performed under local anaesthesia. Methods We prospectively evaluated 85 consecutive patients (62 females) who underwent simultaneous one portal endoscopic bilateral carpal tunnel release with subcutaneous injection of 2 mL 2 % lidocaine. In case of pain after discharge, all patients were advised to take paracetamol (i.e., acetaminophen) and to record the dose of drug taken. Patients were reviewed at regular intervals until one year postoperatively. Results The mean operative time was 31.2 min. Postoperatively, only nine patients (10.6 %) received on average 611 mg of paracetamol. Significant improvement was noticed in the parameters of numbness, pain, positive Phalen and Tinel tests, pinch strength, grip strength, tip pinch strength and Quick DASH Score. Patients returned fully to work after surgery in average 2.2 weeks. Conversion to open release took place in four wrists (2.4 %). Discomfort and pain from tourniquet pressure was reported from two patients (2.4 %). Two wrists (1.2 %) required revision surgery. One patient (1.2 %) reported temporary thenar numbness and another (1.2 %) had slight scar hypersensitivity. Conclusions Simultaneous bilateral endoscopic carpal tunnel release under local anaesthesia is well tolerated by patients. The technique may be of benefit in young, active, high-demand patients who require fast recovery, early return to work and less disability time.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

One portal simultaneous bilateral endoscopic carpal tunnel release under local anaesthesia. Do the results justify the effort?

Chalidis

Dimitriou

2013

International Orthopaedics (SICOT)

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Carpal tunnel syndrome and work

Newington

Harris

Walker‐Bone

2015

Best Practice & Research Clinical Rheumatology

155

127

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INTRODUCTION AND SCOPE Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment syndrome and frequently presents in working-aged adults. Its mild form causes ‘nuisance’ symptoms including dysaesthesia and nocturnal waking. At its most severe however it can significantly impair motor function and weaken pinch grip. This review will discuss the anatomy of the carpal tunnel and the clinical presentation of the syndrome as well as the classification and diagnosis of the condition. Carpal tunnel syndrome has a profile of well-established risk factors including individual factors and predisposing co-morbidities, which will be briefly discussed. However, there is a growing body of evidence for an association between carpal tunnel syndrome and various occupational factors, which will also be discussed. Management of carpal tunnel syndrome, conservative and surgical will be described. Finally, we will discuss the issue of safe return to work post carpal tunnel release surgery and the lack of evidence-based guidelines.

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Bilateral carpal tunnel surgery in one operation: Retrospective study

Herisson¹,

Dury²,

Rapp³

et al. 2016

Hand Surgery and Rehabilitation

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Staged versus Simultaneous Bilateral Endoscopic Carpal Tunnel Release: An Outcome Study

Abstract: In selected patients, bilateral simultaneous endoscopic carpal tunnel release has an outcome similar to that for surgery staged weeks apart. However, patients who choose simultaneous surgery may benefit from a shorter postoperative disability period and earlier return to work.

Cited by 16 publications

References 12 publications

One portal simultaneous bilateral endoscopic carpal tunnel release under local anaesthesia. Do the results justify the effort?

One portal simultaneous bilateral endoscopic carpal tunnel release under local anaesthesia. Do the results justify the effort?

Carpal tunnel syndrome and work

Bilateral carpal tunnel surgery in one operation: Retrospective study

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