A prospective study of prognostic factors for duration of sick leave after endoscopic carpal tunnel release

<p>Abstract</p> <p>Background</p> <p>Endoscopic carpal tunnel release with a single portal technique has been shown to reduce sick leave compared to open carpal tunnel release, claiming to be a less invasive procedure and reducing scar tenderness leading to a more rapid return to work, and the purpose of this study was to identify prognostic factors for prolonged sick leave after endoscopic carpal tunnel release in a group of employed Danish patients.</p> <p>Methods</p> <p>The design was a prospective study including 75 employed patients with carpal tunnel syndrome operated with ECTR at two hospitals. The mean age was 46 years (SD 10.1), the male/female ratio was 0.42, and the mean preoperative duration of symptoms 10 months (range 6-12). Only 21 (28%) were unable to work preoperatively and mean sick leave was 4 weeks (range 1-4). At base-line and at the 3-month follow-up, a self-administered questionnaire was collected concerning physical, psychological, and social circumstances in relation to the hand problem. Data from a nerve conduction examination were collected at baseline and at the 3-month follow-up. Significant prognostic factors were identified through multiple logistic regression analysis.</p> <p>Results</p> <p>After the operation, the mean functional score was reduced from 2.3 to 1.4 (SD 0.8) and the mean symptom score from 2.9 to 1.5 (SD 0.7). The mean sick leave from work after the operation was 19.8 days (SD 14.3). Eighteen patients (24%) had more than 21 days of sick leave. Two patients (3%) were still unable to work after 3 months. Significant prognostic factors in the multivariate analysis for more than 21 days of postoperative sick leave were preoperative sick leave, blaming oneself for the hand problem and a preoperative distal motor latency.</p> <p>Conclusion</p> <p>Preoperative sick leave, blaming oneself for the hand problem, and a preoperative distal nerve conduction motor latency were prognostic factors for postoperative work absence of more than 21 days. Other factors may be important (clinical, demographic, economic, and workplace) in explaining the great variance in the results of sick leave after carpal tunnel release between studies from different countries.</p

Intraarticular osteoid osteoma of the distal humerus

Osteoid osteoma is a small, benign, and painful tumor most commonly affecting the extraarticular portions of the long bones, especially the femur or tibia. Osteoid osteoma of the elbow is uncommon. In this article a 19-year-old man with an osteoid osteoma of the distal humerus is presented to illustrate the diagnostic problems and unusual radiographic features of an intraarticular osteoid osteoma

Bilateral discoid medial menisci: An adult patient with symmetrical radial tears in both knees

A discoid meniscus is a thick meniscus, discoid in shape rather than having the normal semilunar configuration. Discoid meniscus is considered an uncommon lesion; discoid medial meniscus is rare and involvement of the medial meniscus bilaterally is extremely ran. This is the first case report of bilateral discoid medial menisci with symmetrical radial tears. The patient was treated successfully by excision of the central anomalous discoid portion of the menisci, using arthroscopic techniques

A histological study of human derived tooth-hydroxyapatite (THA)

Different types of bone-graft substitutes have been developed and are in the market worldwide to eliminate the drawbacks of autogenous grafting. They vary in composition, strength, osteoinductive and osteoconductive properties, mechanism and rates by which they are resorbed and remodelled. Tooth derived hydroxyapatite (THA) is a novel biomaterial. This study was performed to determine the histological properties of THA on animals. A commercial coralline HA (CHA, Proosteon 200, Interpore Cross, USA) was used as control material. 20 sheeps were used and divided into 2 groups. Human THA (Group A) and CHA (Group B) materials were implanted to the tibiae of 10 sheeps for each group. The histological examinations of surrounding bone response were done 12 weeks after implantation. There was no significant difference histologically between group A and B. All materials were found to be surrounded by new bone tissue. THA was found to be as efficient as the standard CHA on histological basis. In addition, economical production of THA should be taken into consideration. Therefore, THA may be a viable alternative on bone grafting provided that clinical trials will be completed