The American Academy of Orthopaedic Surgeons (AAOS) has developed Appropriate Use Criteria (AUC) for Management of Carpal Tunnel Syndrome. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. To provide the evidence foundation for this AUC, the AAOS Evidence-Based Medicine Unit provided the writing panel and voting panel with the 2016 AAOS Clinical Practice Guideline titled Management of Carpal Tunnel Syndrome Evidence-Based Clinical Practice Guideline. The Management of Carpal Tunnel Syndrome AUC clinical patient scenarios were derived from indications typical of patients with suspected carpal tunnel syndrome in clinical practice, as well as from current evidence-based clinical practice guidelines and supporting literature to identify the appropriateness of treatments. The 135 patient scenarios and 6 treatments were developed by the writing panel, a group of clinicians who are specialists in this AUC topic. Next, a separate, multidisciplinary, voting panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as Appropriate (median rating, 7 to 9), May Be Appropriate (median rating, 4 to 6), or Rarely Appropriate (median rating, 1 to 3).
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http://dx.doi.org/10.5435/JAAOS-D-17-00451 | DOI Listing |
Acad Radiol
January 2025
Department of Orthopedics and Traumatology, Samsun University Faculty of Medicine, Samsun, Turkey (A.E.O.).
Rationale And Objectives: This study aimed to evaluate the efficacy of ultrasound (US)-guided local steroid injection in carpal tunnel syndrome (CTS) using shear wave elastography (SWE).
Materials And Methods: A total of 47 wrists from 41 patients diagnosed with mild to moderate idiopathic CTS, based on clinical and electrophysiological criteria, were enrolled between June and October 2024. All participants underwent US-guided local steroid injection.
J Hand Surg Eur Vol
January 2025
Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
This study assessed the effectiveness of adding leukocyte-poor platelet-rich plasma (PRP) during carpal tunnel release surgery for patients with moderate to severe carpal tunnel syndrome. In a randomized controlled trial, 70 patients were assigned to either standard carpal tunnel release (control group) or release with leukocyte-poor PRP applied to the median nerve (PRP group). Primary outcomes were measured using the Boston Carpal Tunnel Questionnaire at 3 months, and secondary outcomes included pain, strength, sensation and electrodiagnostic examinations at multiple time points.
View Article and Find Full Text PDFZhongguo Zhen Jiu
January 2025
Department of Acupuncture and Moxibustion, China-Japan Friendship Hospital, Beijing 100029, China.
Visual minimally invasive acupotomy is applicable for the diseases with the pathological characteristics of soft tissue injury, including disorders of spine, four limbs and joints, peripheral nerve compression and chronic soft tissues. The diseases with superior effect obtained are cervicogenic headache, lumbar disc herniation, carpal tunnel syndrome and flexor tendon stenosing tenosynovitis. Under the guidance with ultrasound, visual minimally invasive acupotomy is advantaged at preoperative diagnosis, intraoperative guidance and postoperative evaluation in clinical practice so that it is precise, safe and reliable in clinical treatment.
View Article and Find Full Text PDFZhongguo Zhen Jiu
January 2025
Department of Pain Medicine, Suizhou Hospital of Hubei University of Medicine, Suizhou 441300, China.
Objective: To evaluate the clinical efficacy of ultrasound-guided needle knife release with different pathways for carpal tunnel syndrome (CTS).
Methods: Sixty CTS patients were randomly divided into a transverse group and a longitudinal group, with 30 patients in each group. The transverse group received the needle knife release under ultrasound above and below the median nerve along the short axis, while the longitudinal group received the needle knife release under ultrasound above the median nerve along the long axis.
Surg Neurol Int
December 2024
Department of Surgery, Medical College, King Faisal University, Hofuf, Ahsa, Saudi Arabia.
Background: Carpal tunnel syndrome (CTS) is a common nerve entrapment condition, and there is ongoing debate regarding the superiority of traditional open versus minimally invasive carpal tunnel surgery.
Methods: This meta-analysis reviewed six studies involving 478 patients to compare recovery and functional outcomes between the traditional longitudinal technique and the minimally invasive mini-transverse technique. The primary outcomes included the functional status scale (FSS), symptoms severity scale (SSS), pain scores, time to return to work, duration of operation, and incidence of complications.
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