Study to Assess Outcome After Open and Closed Carpal Tunnel Decompression.

Carpal tunnel decompression (CTD) is the most commonly performed surgical procedure within a hand unit. We have analyzed data on outcomes after carpal decompression performed by both open and closed techniques to assess whether outcomes differed between the 2 procedures. Data were jointly gathered from 2 units.

A prospective, longitudinal outcome study of patients with carpal tunnel surgery and the relationship of body mass index.

This study investigated whether body mass index (BMI) was associated with effectiveness of carpal tunnel release as measured by physical and self-assessment tests. This prospective, longitudinal study was conducted from March 2001 to March 2003 using 598 cases (hands) diagnosed with carpal tunnel syndrome and scheduled for surgery at The Curtis National Hand Center, Baltimore, Maryland, and at the Pulvertaft Hand Centre, Derby, England. Body mass index was calculated, and demographic, clinical, and functional data were collected preoperatively and at 6-month follow-up.

A proposal justifying an alternative referral practice from primary care for three common hand surgery diagnoses.

A hand therapy primary care clinic offering advice on task modification at work and in the home and the use of splints was found to almost halve referrals of carpal tunnel syndrome from a single primary care trust. Dorsal ganglion aspiration and steroid injection for trigger digits can also be safely performed in primary care, further reducing the need for hospital care.

Primary care management of patients with carpal tunnel syndrome referred to surgeons: are non-operative interventions effectively utilised?

Aim: To investigate the non-operative primary care management (splintage, task modification advice, steroid injections and oral medications) of carpal tunnel syndrome before patients were referred to a hand surgeon for decompression.

Design And Setting: Preoperative data were obtained on age, gender, body mass index, employment, symptom duration, and preoperative clinical stage for patients undergoing carpal tunnel decompression (263 in the USA, 227 in the UK).

Results: Primary care physicians made relatively poor use of beneficial treatment options with the exception of splintage in the US (73% of cases compared with 22.

Relationship between the duration and severity of symptoms and the outcome of carpal tunnel surgery.

Purpose: There is no consensus regarding the prognostic value of preoperative symptom severity and duration for determining the anticipated results of carpal tunnel release. Some studies show a detrimental influence of symptom duration and severity on outcomes; others have found no effect. To study these contradictions, a database was created at 2 separate hand centers to explore the extent to which the duration and severity of symptoms before surgery are predictive of surgical outcome.

Trends in elective hand surgery referrals from primary care.

Introduction: Two prospective audits of activity in a hand unit were performed, in 1989-1990 and during 2000-2001, to identify trends in elective hand surgery referrals from primary care.

Patients And Methods: Two 6-month prospective audits of activity in a hand unit were performed, including elective referrals from primary care. Data were collected on all in-district referrals with elective hand disorders.

Carpal tunnel syndrome, the search for a cost-effective surgical intervention: a randomised controlled trial.

Objective: There is insufficient evidence regarding the clinical and cost-effectiveness of surgical interventions for carpal tunnel syndrome. This study evaluates the cost, effectiveness and cost-effectiveness of minimally invasive surgery compared with conventional open surgery.

Patients And Methods: 194 sufferers (208 hands) of carpal tunnel syndrome were randomly assigned to each treatment option.