Wrist immobilization after carpal tunnel release: a prospective study

Martins, Roberto S.; Siqueira, Mário G.; Simplício, Hougelli

doi:10.1590/s0004-282x2006000400013

Cited by 31 publications

(13 citation statements)

References 20 publications

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“…After surgery, immobilization [9][10][11][12][13][14][15] and referral to supervised physiotherapy [16][17][18][19][20] have not been shown to be of benefit compared with home exercise programs. Despite this evidence, there are surgeons who still routinely send patients for physiotherapy and immobilize after surgery in both the ASSH and the CSPS groups surveyed.…”

Section: Discussionmentioning

confidence: 99%

Canadian Trends in Carpal Tunnel Surgery

Peters

Giuffre

2018

The Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 99%

Canadian Trends in Carpal Tunnel Surgery

Peters

Giuffre

2018

The Journal of Hand Surgery

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“…7 Since this report, multiple studies have investigated the benefit of several postoperative therapy modalities, including splinting, electrical stimulation, cold treatment, contrast baths, extremity elevation, topical application of herbal remedies, and a comprehensive rehabilitation regimen. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Some of these investigations suggest that postoperative rehabilitation is beneficial, while most of the studies conducted suggest that there is no benefit and that the additional cost is unjustifiable. In 2013, Peters et al performed a comprehensive review of the studies that have investigated the benefit of postoperative 812155H ANXXX10.1177/1558944718812155HANDGil et al research-article2018 1 The Warren Alpert Medical School of Brown University, Providence, RI, USA rehabilitation after carpal tunnel release.…”

Section: Introductionmentioning

confidence: 99%

A Prospective Evaluation of the Effect of Supervised Hand Therapy After Carpal Tunnel Surgery

Gil

Weiss

Kleiner

et al. 2018

Hand (New York, N,Y.)

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Background: The objective of this investigation is to examine the effect of postoperative therapy after routine carpal tunnel release. Our hypothesis was that supervised hand therapy does not improve outcomes after routine carpal tunnel release. Methods: Patients with carpal tunnel syndrome were randomly assigned to one of 3 groups based on the last digit of their medical record numbers to one of 3 groups: standard 6-week postoperative rehabilitation (standard therapy), expedited one-session postoperative rehabilitation group (expedited therapy), and no postoperative rehabilitation group (no therapy). The primary outcome measures were Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and return to work. The outcome questionnaire was completed preoperatively, at the 2-week follow-up visit, and monthly to 6 months after surgery. Results: All 3 treatment groups had similar mean QuickDASH scores preoperatively. At 1- to 6-month follow-up, all 3 groups had similar QuickDASH scores at each visit, and all showed a significant decline from baseline (preoperative) QuickDASH score. Overall, QuickDASH score decreased significantly from a preoperative visit mean of 42.7 to a final postoperative (visit 8) mean of 6.69. There was no significant difference in the mean QuickDASH score among all 3 groups at 6-month follow-up. There was no significance in the time of return to work among the 3 groups (standard therapy, 21.8 days; expedited therapy, 20.9 days; no therapy, 16.6 days). Conclusions: This investigation adds evidence that supervised hand therapy does not improve the outcomes of routine carpal tunnel surgery as measured by QuickDASH and return to work.

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“…Previous studies have found no significant difference between the postoperative methods concerning function ( 4 , 5 ), pain ( 6 , 7 ), hand strength ( 7 ), sensibility ( 8 ), complications ( 5 , 7 , 8 ), and continuing symptoms using self-assessment ( 3 , 4 , 8 , 9 ), while more pain and impaired strength with plaster casting in the short term was indicated in one study ( 5 ). Many previous studies had a limited number of patients and showed wide disparity regarding the number of days with a cast (2–21 days), the degree of mobilization of patients without a cast, treatment procedures, follow-up time-points and outcome measures ( 4 – 8 , 10 ). Hence, a need for a prospective randomized multifactorial study that evaluates rehabilitation with or without cast treatment following carpal tunnel release has been proposed ( 9 , 11 ).…”

mentioning

confidence: 75%

Comparison of use of plaster casting versus elastic bandage following carpal tunnel release: a randomized controlled study

Svegard¹,

Persson²,

Zetterlund³

et al. 2021

J Rehabil Med

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Objective To compare the effects of two postoperative regimens following carpal tunnel release; plaster casting and elastic bandaging. Design A randomized controlled study. Patients Patients with carpal tunnel syndrome and planned surgical carpal tunnel release were invited to participate. Methods A total of 94 patients were randomized to either plaster casting or elastic bandaging to be used 2 weeks postoperatively. Muscle strength, pain rated on a visual analogue scale, range of movement, sensibility, oedema, and different scores regarding symptoms and function were measured before and 2, 4, 6, 8 and 26 weeks after surgery. Results No differences were found between the 2 groups for any measurement, except for the DASH (Disability of the Arm, Shoulder and Hand) Health Score and daily function, rated 2 weeks postoperatively, in which the bandage group scored better. Both groups improved significantly over time for all measurements, sensibility was improved after 2 weeks, while strength was not fully recovered until week 26. Conclusion Following carpal tunnel release no benefits were found in using plaster casting, compared with elastic bandaging. Among these patients there was more discomfort during plaster casting compared with elastic bandaging; therefore plaster casting is not recommended following this type of surgery. LAY ABSTRACT No clear consensus exists regarding benefits of use of plaster casting following carpal tunnel release. This study aimed to compare two different postoperative regimens in a randomized controlled study. A total of 94 patients were randomized to either plaster casting or elastic bandage to be used for 2 weeks after surgery for carpal tunnel release. Muscle strength, rated pain, range of movement, sensibility, oedema, and different scores regarding symptoms and function were measured before and 2, 4, 6, 8 and 26 weeks after surgery. No differences were found between the 2 groups for any measurement, except for health score and rated daily function 2 weeks postoperatively, in which the bandage group scored better. Both groups improved significantly over time for all measurements, sensibility was improved after 2 weeks, while strength was not fully recovered until week 26. This study found no benefits, but some disadvantages, of plaster casting following carpal tunnel release, and therefore plaster casting is not recommended for these patients.

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Wrist immobilization after carpal tunnel release: a prospective study

Cited by 31 publications

References 20 publications

Canadian Trends in Carpal Tunnel Surgery

Canadian Trends in Carpal Tunnel Surgery

A Prospective Evaluation of the Effect of Supervised Hand Therapy After Carpal Tunnel Surgery

Comparison of use of plaster casting versus elastic bandage following carpal tunnel release: a randomized controlled study

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