Microsurgical open mini uniskin incision technique in the surgical treatment of carpal tunnel syndrome

Background: Patients who undergo carpal tunnel surgery sometimes complain of the restriction of the grip and pinch function, palmar tenderness, cosmetic problems, and scar formation at the site of the incision. Aims: We used a modified mini uni-skin incision with appropriate hand position for microscopic view in the surgical treatment of carpal tunnel syndrome to prevent cosmetic problems related with scar formation after surgery. Settings and Design: In this study we used two different skin incision techniques; mini uni-skin incision and standard incision. In mini uni-skin incision technique the hands were positioned in a way that the wrist are hyperextended. A small skin incision one cm long was done from the inferior flexion crease towards the point between the thirth and fourth fingers. Materials and Methods: Standard incision and mini uni-skin incision were compared according to their cosmetic result, grip and pinch function, palmar tenderness, and painful scar formation. Statistical analysis: Student -t test was used for this study. Results: 56 (43%) patients were operated with mini uni-skin incision, and 73 (57%) cases were operated with standard incision. The scores of grip, pinch and cosmetic results were better in the patients who were operated with mini uni-skin incision technique from those of standard incision. Conclusion: In this clinical study we used a modified skin incision (mini uni-skin incision) technique in the surgical treatment of carpal tunnel surgery. Our results revealed that mini uni-skin incision is superior from the standard incision

Quantitative assessment of muscle stiffness with acoustic radiation force impulse elastography after botulinum toxin A injection in children with cerebral palsy

WOS: 000418965300019PubMed: 28271231Our objective in this study was to assess the changes in medial gastrocnemius muscle (GCM) stiffness after botulinum toxin A (BTA) injection in children with cerebral palsy (CP) by using acoustic radiation force impulse (ARFI) elastography and to research the usability of this technique in clinical practice. Twenty-four spastic lower extremities of 12 children with CP were assessed. BTA injection treatment was applied to the medial GCM. Muscle stiffness was measured with the ARFI technique before the procedure and a month after the procedure. The patients were assessed with the modified Ashworth scale (MAS) in the physiotherapy department at about the same time. Shear wave velocity (SWV) values and MAS scores before and after the treatment were compared. Mean SWV values were measured as 3.20 +/- 0.14 m/s before BTA and as 2.45 +/- 0.21 m/s after BTA, and the difference between them was found to be statistically significant (p < 0.001). Mean MAS score (2.33 +/- 0.70) after BTA decreased significantly when compared to the score before BTA (2.96 +/- 0.62) (p = 0.001). SWV values positively correlated with MAS scores (rho = 0.578, p = 0.003). The interobserver agreement expressed as interclass correlation coefficient (ICC) was 0.65 (95% CI 0.33-0.84, p < 0.001). ARFI elastography for identifying structural changes that occur in the spastic muscle after BTA injection in children with CP can yield more valuable information with combined use of MAS

Prevalence of juvenile fibromyalgia syndrome in an urban population of Turkish adolescents: impact on depressive symptoms, quality of life and school performance

Background Juvenile Fibromyalgia Syndrome (JFMS) is a chronic health condition characterized by widespread musculoskeletal pain and multiple tender points (TP). The objective of this study was to determine the prevalence of JFMS in the urban population of Samsun and to determine the impact of JFMS on depression symptoms, school performance and quality of life (QOL)