M C Jansen1, S Evers2, H P Slijper3, K P de Haas4, X Smit3, S E Hovius3, R W Selles2. 1. Department of Plastic, Reconstructive and Hand Surgery, Rotterdam, the Netherlands; Department of Rehabilitation Medicine, Erasmus Medical Center, Rotterdam, the Netherlands. Electronic address: 365607mj@student.eur.nl. 2. Department of Plastic, Reconstructive and Hand Surgery, Rotterdam, the Netherlands; Department of Rehabilitation Medicine, Erasmus Medical Center, Rotterdam, the Netherlands. 3. Department of Plastic, Reconstructive and Hand Surgery, Rotterdam, the Netherlands; Department of Plastic, Reconstructive and Hand Surgery, Xpert Clinic, Rotterdam, the Netherlands. 4. Department of Plastic, Reconstructive and Hand Surgery, Xpert Clinic, Rotterdam, the Netherlands.
Abstract
PURPOSE: Carpal tunnel release (CTR) is typically offered to symptomatic patients with electrophysiological abnormalities when night orthoses no longer prevent waking with numbness and preferably before there is any static numbness, weakness, or atrophy. The ability to predict the amount of symptom relief after CTR could be beneficial for managing patient expectations and, therefore, improve treatment satisfaction. Therefore, the aim of this study was to identify predictors for symptom relief after CTR and to determine their contribution to symptom relief at 6 months after surgery. METHODS: A total of 1,049 patients who underwent CTR between 2011 and 2015 at 1 of 11 Xpert Clinics in the Netherlands were asked to complete online questionnaires at intake and 3 and 6 months after surgery. Patient demographics, comorbidities, and baseline scores were considered potential predictors for the amount of symptom relief on the Boston Carpal Tunnel Questionnaire (BCTQ) score, which was the primary outcome measure. RESULTS: A low score on the BCTQ at intake, a codiagnosis of a trigger finger, ulnar nerve neuropathy, trapeziometacarpal joint arthrosis, and instability or arthrosis of the wrist were associated with a smaller improvement in the BCTQ domains after a CTR at 6 months after surgery and accounted for 35% to 42% of the variance on the BCTQ domains in our multivariable regression models. CONCLUSIONS: In this study, we showed that clinical severity of carpal tunnel syndrome at intake is the most important factor in estimating symptom relief after surgical treatment. Furthermore, this study contributes to a more precise understanding of the capabilities of CTR in relieving symptoms for different subgroups of patients. Results of our study can be used to manage patient expectation on symptom relief from CTR. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.
PURPOSE: Carpal tunnel release (CTR) is typically offered to symptomatic patients with electrophysiological abnormalities when night orthoses no longer prevent waking with numbness and preferably before there is any static numbness, weakness, or atrophy. The ability to predict the amount of symptom relief after CTR could be beneficial for managing patient expectations and, therefore, improve treatment satisfaction. Therefore, the aim of this study was to identify predictors for symptom relief after CTR and to determine their contribution to symptom relief at 6 months after surgery. METHODS: A total of 1,049 patients who underwent CTR between 2011 and 2015 at 1 of 11 Xpert Clinics in the Netherlands were asked to complete online questionnaires at intake and 3 and 6 months after surgery. Patient demographics, comorbidities, and baseline scores were considered potential predictors for the amount of symptom relief on the Boston Carpal Tunnel Questionnaire (BCTQ) score, which was the primary outcome measure. RESULTS: A low score on the BCTQ at intake, a codiagnosis of a trigger finger, ulnar nerve neuropathy, trapeziometacarpal joint arthrosis, and instability or arthrosis of the wrist were associated with a smaller improvement in the BCTQ domains after a CTR at 6 months after surgery and accounted for 35% to 42% of the variance on the BCTQ domains in our multivariable regression models. CONCLUSIONS: In this study, we showed that clinical severity of carpal tunnel syndrome at intake is the most important factor in estimating symptom relief after surgical treatment. Furthermore, this study contributes to a more precise understanding of the capabilities of CTR in relieving symptoms for different subgroups of patients. Results of our study can be used to manage patient expectation on symptom relief from CTR. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.
Authors: Mohammad Hosseini-Farid; Verena J M M Schrier; Julia Starlinger; Peter C Amadio Journal: J Ultrasound Med Date: 2020-10-19 Impact factor: 2.153
Authors: Verena J M M Schrier; Stefanie Evers; Jennifer R Geske; Walter K Kremers; Hector R Villarraga; Sanjeev Kakar; Ruud W Selles; Steven E R Hovius; Russell Gelfman; Peter C Amadio Journal: Ultrasound Med Biol Date: 2019-09-02 Impact factor: 2.998
Authors: Conrad J Harrison; Luke Geoghegan; Chris J Sidey-Gibbons; Paul H C Stirling; Jane E McEachan; Jeremy N Rodrigues Journal: Plast Reconstr Surg Glob Open Date: 2022-04-18
Authors: Reinier Feitz; Yara E van Kooij; Marloes H P Ter Stege; Mark J W van der Oest; J Sebastiaan Souer; Robbert M Wouters; Harm P Slijper; Ruud W Selles; Steven E R Hovius Journal: EFORT Open Rev Date: 2021-06-28