Evaluation of patients with carpal tunnel syndrome treated by endoscopic technique

Objective:To evaluate the postoperative results of patients with carpal tunnel syndrome by the endoscopic release technique with single portal.Methods:78 patients (80 wrists) were evaluated preoperatively and postoperatively at 1, 3 and 6 months by the Boston questionnaire, the visual analogue scale (VAS) for pain, monofilament test sensitivity, grip strength, lateral pinch, pulp to pulp pinch and tripod pinch.Results:Statistical analysis was significant (p <0.05) in the progressive decline of pain and improved function (Boston) during follow-up. The sensitivity significantly improved comparing the data pre and postoperatively. The grip strength, lateral pinch, pulp to pulp pinch and tripod pinch decreased in the first month after surgery, returning to preoperative values around the third month postoperatively.Conclusion:The technique proved to be safe and effective in improving pain, function, and return sensitivity and strength. Level of Evidence II, Prospective studyUniversidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Long-term clinical evaluation - by Phalen, Tinel sign and night paresthesia - of patients submitted to carpal tunnel release surgery with Paine® retinaculatome

The release of flexors retinaculum for carpal tunnel syndrome (CTS) treatment is one of the most frequently performed surgeries. There are many methods for performing this surgical procedure, such as endoscopic, classical open port and mini-incisions. Few papers show the long-term results of those surgeries. This study is aimed to evaluate patients submitted to carpal tunnel syndrome release using the Paine® instrument, in at least 84 months postoperatively. The following clinical parameters were assessed: Phalen test, painful percussion sign, and complaints of nighttime paresthesia pre- and postoperatively. The results show that there is a significant improvement of the signs assessed (p.....), when compared to baseline evaluation, and that those clinical signs remain negative with time.A liberação do retináculo dos flexores para o tratamento da síndrome do túnel do carpo (STC) é uma das cirurgias mais realizadas. Existem diversos métodos para a realização deste procedimento cirúrgico, como endoscópicos, via aberta clássica e mini-incisões. A longo prazo, poucos trabalhos mostram os resultados destas cirurgias. Este estudo tem como finalidade avaliar os pacientes submetidos à liberação do túnel do carpo com instrumento de Paine®, com no mínimo 84 meses de pós-operatório. Foram avaliados os parâmetros clínicos: teste de Phalen, sinal da percussão dolorosa e a queixa de parestesia noturna no pré e pós-operatório. Os resultados mostram que há significante melhora dos sinais avaliados (p.....), quando comparados com a avaliação inicial, e que estes sinais clínicos permanecem negativos ao longo do tempo.UNIFESP Departamento de Ortopedia e TraumatologiaUNIFESP, Depto. de Ortopedia e TraumatologiaSciEL

A Prevalência Da Síndrome Do Túnel Do Carpo Em Atletas De Esportes Adaptados

Objective: The Objective Of This Study Was To Verify The Prevalence Of Carpal Tunnel Syndrome In People With Disabilities Who Practice Adapted Sports, In Which They Use Palmar Grip Or Palmar Support During Their Sports Activities. Methods: A Cross-Sectional Study Was Carried Out With Adapted Athletes, Who Practiced Weightlifting, Wheelchair Basketball, Fencing In A Wheelchair, Sitting Volleyball, Table Tennis In Wheelchairs And Capoeira, Which Were Evaluated In The Following Outcomes: Presence Of Pain, Presence Of Nocturnal Paresthesia, Tinel Signal, Phalen Test, Intensity Of Signs And Symptoms, And Functional Status Of The Hand. To Evaluate The Intensity Of Pain, The Numerical Scale Of Pain Was Applied. For The Evaluation Of Nocturnal Paresthesia The Athletes Were Asked About The Presence Of This Symptom. The Presence Of Tinel Signal And Phalen Test Were Evaluated. Regardless Of The Complaints, Two Self-Assessment Tools Were Applied To Assess The Intensity Of Signs And Symptoms And Functional Status Of The HObjetivo: O Objetivo Deste Estudo Foi Verificar A Prevalência Da Síndrome Do Túnel Do Carpo Em Pessoas Com Deficiência Que Praticam Esporte Adaptado, Na Qual Utilizam A Preensão Palmar Ou Apoio Palmar Durante Suas Atividades Esportivas. Métodos: Foi Realizado Um Estudo Transversal Com Atletas De Esporte Adaptado, Que Praticavam Halterofilismo, Basquete Em Cadeira De Rodas, Esgrima Em Cadeira De Rodas, Vôlei Sentado, Tênis De Mesa Em Cadeira De Rodas E Capoeira Que Foram Avaliados Nos Seguintes Desfechos: Presença De Dor, Presença De Parestesia Noturna, Pesquisa De Sinal De Tinel, Presença Do Teste De Phalen, Intensidade Dos Sinais E Sintomas E Estado Funcional Da Mão. Para Avaliação Da Intensidade De Dor Foi Aplicada A Escala Numérica De Dor. Para Avaliação Da Parestesia Noturna Foi Perguntado Aos Atletas Sobre A Presença Desse Sintoma. Para Avaliação Dos Sinais Foi Realizada A Pesquisa De Sinal De Tinel E O Teste De Phalen. Independente Das Queixas, Foram Aplicadas Duas Ferramentas De Auto-Avaliação Para AvaDados abertos - Sucupira - Teses e dissertações (2018

An Intraindividual Comparison of Open versus Paine Retinaculotome Release for Bilateral Carpal Tunnel Syndrome

Abstract The main purpose of this research was to do an intraindividual comparison of outcomes between the open ulnar incision (OUI) and the Paine retinaculotome with palmar incision (PRWPI) techniques in patients with bilateral carpal tunnel syndrome (CTS). The patients underwent OUI surgery on one hand and PRWPI surgery on the contralateral hand. The patients were evaluated with the Boston carpal tunnel questionnaire, visual analogue scale for pain, palmar grip strength, and fingertip, key, and tripod pinch strengths. Both hands were examined in the preoperative and postoperative periods after 2 weeks, 1 month, and 3 and 6 months. Eighteen patients (36 hands) were evaluated. The symptoms severity scale (SSS) scores were higher, in the preoperative period, in the hands that underwent surgery with PRWPI (p-value =0,023), but lower in the 3rd month postoperative (p-value = 0.030). The functional status scale (FSS) scores were lower in the periods of 2 weeks, 3 months, and 6 months (p-value = 0,016) on the hands that underwent surgery with PRWPI. In a different two-group module study, the PRWPI group presents the SSS scores average on the 2nd week and 1st month, and the FSS scores average on the 2nd week, less 0.8 and 1.2 points respectively comported to open group. The hands that underwent surgery with PRWPI presented significantly lower SSS scores at 3 months postoperative, and lower FSS scores at 2 weeks, and 3 and 6 months postoperative, compared to open surgery group

Intra-individual evaluation of results between open and endoscopic release in bilateral carpal tunnel syndrome

ABSTRACT Objective: The authors performed an intra-individual comparison of surgical results between the open and endoscopic surgical techniques in patients with bilateral carpal tunnel syndrome. Each hand was submitted to surgery using one of these techniques. Methods: Fifteen patients (30 hands) were evaluated by the Boston Questionnaire, visual analogue pain scale, palmar grip strength, and for tip, key, and tripod pinch strengths. These measurements were taken before surgery and at two weeks, one month, three months, and six months after the procedure. Scores for each evaluation tool in each evaluation time period were compared. Results: In comparison to the group submitted to open surgery, the group submitted to endoscopic surgery had worse scores in the evaluation of the 1st and 6th postoperative months regarding the severity of the symptoms. The authors found no differences in the functional status of the hand. Regarding the intensity of pain evaluated by the visual analogue pain scale, no difference was found between the averages in all time periods evaluated. No differences in palmar grip strength and in fingertip, key (lateral), and tripod pinch strengths were found in all time periods. There were no differences between averages in the preoperative period at two weeks, one month, and three months after surgery. After six months, the group of patients submitted to open surgery presented greater tripod force than the group of patients who underwent endoscopic surgery. Conclusion: No differences were observed by using the intra-individual evaluation in the results between open and endoscopic techniques for the treatment of carpal tunnel syndrome