Optimizing Costs and Outcomes for Carpal Tunnel Release Surgery

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Miranda J. Rogers ◽  
Andrew R. Stephens ◽  
Minkyoung Yoo ◽  
Richard E. Nelson ◽  
Nikolas H. Kazmers
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Carpal Tunnel Release Surgery

The Influence of Illness Perception and Mental Health on Return to Work After Carpal Tunnel Release Surgery

2021 ◽  
Vol 46 (9) ◽  
pp. 748-757
Author(s):  
Miguel C. Jansen ◽  
Mark J.W. van der Oest ◽  
Nicoline P. de Haas ◽  
Ruud W. Selles, PhD ◽  
J. Michiel Zuidam, MD, PhD ◽  
...  
Keyword(s):  
Mental Health ◽  
Return To Work ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Illness Perception ◽  
Carpal Tunnel Release Surgery

scholarly journals Outcome of carpal tunnel release surgery in patients with diabetes

1997 ◽  
Vol 3 (1) ◽  
pp. E12 ◽  
Author(s):  
David M. Pagnanelli ◽  
Steven J. Barrer
Keyword(s):  
Carpal Tunnel ◽  
Associated Factors ◽  
Carpal Tunnel Release ◽  
Clinical Findings ◽  
Cervical Disc ◽  
Control Group ◽  
Disc Disease ◽  
Postoperative Results ◽  
Patients With Diabetes ◽  
Carpal Tunnel Release Surgery

The surgical outcomes in 149 patients with diabetes and carpal tunnel syndrome who underwent transverse carpal ligament release surgery are reported. Associated factors such as insulin dependence, length of time with diabetes, electrodiagnostic studies, severity of neurological deficit, presence of polyneuropathy, and cervical disc disease were considered. Analysis of preoperative and postoperative symptoms, clinical findings, diagnostic studies, and patient self-assessment indicated that the majority of patients with diabetes experienced a favorable surgical outcome, regardless of any associated factors. Eighty-four percent of the patients reported good to excellent postoperative results in their hands. Further analysis of the subpopulation of insulin-dependent diabetics showed that 81% experienced good to excellent postoperative results. These results compare favorably with those of the control group: 200 nondiabetic patients, of whom 90% rated their results from carpal tunnel release surgery as good to excellent. There were no major complications in any group.

Endoscopic Carpal Tunnel Release

2019 ◽  
pp. 989-994
Author(s):  
Antony Hazel ◽  
Neil F. Jones
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Hand Surgery ◽  
Anatomical Landmarks ◽  
Transverse Carpal Ligament ◽  
Palmar Arch ◽  
Endoscopic Carpal Tunnel Release ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Release Surgery ◽  
Open Carpal Tunnel Release

Conventional open carpal tunnel release surgery is one of most successful procedures in hand surgery and has been demonstrated to be an effective treatment for carpal tunnel syndrome. However, a known sequelae in some individuals who undergo the procedure is “pillar” pain. In an effort to avoid this condition and help people return to work more quickly, the endoscopic technique was developed. Endoscopic carpal tunnel release offers a minimally invasive alternative to other traditional techniques with similar outcomes. By placing the incision proximal to the transverse carpal ligament there is potential for decreased scar sensitivity and pillar pain. The technique is technically demanding. The superficial palmar arch and common digital nerve to the ring and middle fingers are at risk for injury during the procedure. With adherence to anatomical landmarks and the proper visualization, the surgery may be safely performed.

scholarly journals Validation of an Online Assessment of Orthopedic Surgery Residents' Cognitive Skills and Preparedness for Carpal Tunnel Release Surgery

2010 ◽  
Vol 2 (3) ◽  
pp. 435-441 ◽  
Author(s):  
Janet Shanedling ◽  
Ann Van Heest ◽  
Michael Rodriguez ◽  
Matthew Putnam ◽  
Julie Agel
Keyword(s):  
Construct Validity ◽  
Carpal Tunnel ◽  
Cognitive Skills ◽  
Carpal Tunnel Release ◽  
Technical Skills ◽  
Skills Assessment ◽  
Validity And Reliability ◽  
School Students ◽  
Internal Reliability ◽  
Carpal Tunnel Release Surgery

Abstract Background Surgical competence requires both cognitive and technical skills. Relatively little is found in the literature regarding the value of Web-based assessments to measure surgery residents' mastery of the competencies. Objective To determine the validity and reliability of 2 online instruments for predicting the cognitive preparedness of residents for performing carpal tunnel release surgery. Method Twenty-eight orthopedic residents and 2 medical school students responded to an online measure of their perception of preparedness and to an online cognitive skills assessment prior to an objective structured assessment of technical skills, in which they performed carpal tunnel release surgery on cadaveric specimens and received a pass/fail assessment. The 2 online assessments were analyzed for their internal reliability, external correlation with the pass/fail decision, and construct validity. Results The internal consistency of the perception of preparedness measure was high (α  =  .92) while the cognitive assessment was less strong (α  =  .65). Both instruments demonstrated moderately strong correlations with the pass/fail decision, with Spearman correlation of .606 (P  =  .000) and .617 (P  =  .000), respectively. Using logistic regression to analyze the predictive strength of each instrument, the perception of preparedness measure demonstrated a 76% probability (η2  =  .354) and the cognitive skills assessment a 73% probability (η2  =  .381) of correctly predicting the pass/fail decision. Analysis of variance modeling resulted in significant differences between levels at P < .005, supporting good construct validity. Conclusions The online perception of preparedness measure and the cognitive skills assessment both are valid and reliable predictors of readiness to successfully pass a cadaveric motor skills test of carpal tunnel release surgery.

scholarly journals Return to work recommendations after carpal tunnel release: a survey of UK hand surgeons and hand therapists

2018 ◽  
Vol 43 (8) ◽  
pp. 875-878 ◽  
Author(s):  
Lisa Newington ◽  
Kristin Francis ◽  
Georgia Ntani ◽  
David Warwick ◽  
Jo Adams ◽  
...  
Keyword(s):  
Return To Work ◽  
Carpal Tunnel ◽  
Current Practice ◽  
Carpal Tunnel Release ◽  
Evidence Base ◽  
British Society ◽  
Level Of Evidence ◽  
Functional Activities ◽  
Different Types ◽  
Carpal Tunnel Release Surgery

There is a limited evidence base from which to derive recommendations for safe and effective return to different types of occupation after carpal tunnel release surgery. The current practice of members of the British Society for Surgery of the Hand and the British Association of Hand Therapists was investigated with a questionnaire. In total, 173 surgeons and 137 therapists responded from an estimated sample of 1959. Median recommended return-to-work times were 7 days for desk-based duties, 15 days for repetitive light manual duties and 30 days for heavy manual duties. However, the responses were wide-ranging: 0–30 days for desk-based; 1–56 days for repetitive light manual; and 1–90 days for heavy manual. Variation in the recommended timescales for return to work and other functional activities after carpal tunnel release suggests that patients are receiving different and possibly even conflicting advice. Level of evidence: V

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