Article

Retrospective case series. INTRODUCTION: Open carpal tunnel release
(OCTR) is a common treatment for carpal tunnel syndrome, but there is no
consensus on the number of hand therapy visits needed to achieve optimal patient
outcomes. PURPOSE : The purpose is to examine changes in
patient-reported symptoms and function over a 12-week period after OCTR with 1
postoperative hand therapy visit. METHODS: Eligible subjects were consecutive
patients treated with a standard OCTR protocol by a fellowship trained hand
surgeon that included 1 hand therapy visit at 10-14 days postoperatively.
Patients were excluded from participation if they had additional surgery at the
time of OCTR, had another upper extremity diagnosis that required therapeutic
intervention, or received more or less than 1 visit of hand therapy. Responses on
the Boston Carpal Tunnel Questionnaire (BCTQ) were collected at preoperative and
3 postoperative time points: at the hand therapy visit, 6 weeks, and 12 weeks.
Change over time in the BCTQ Symptom Severity Scale and Functional Status Scale
was assessed. RESULTS: A total of 134 patients who were treated with the standard
protocol had a complete BCTQ data set. Both BCTQ scales showed significant
improvement over time. The Symptom Severity Scale showed significant improvement
by the hand therapy visit at 10-14 days postoperatively, whereas significant
improvement on the Functional Status Scale did not occur until 6 weeks
postoperatively. The magnitude of change from preoperative to 12 weeks
postoperative was 1.51 points on the Symptom Severity Scale and 0.91 points on
the Functional Status Scale. Complication rates were low with an incidence of 13%
for pillar pain and palm pain combined. CONCLUSIONS: Patient-reported symptoms
and function improved significantly up to 12 weeks after OCTR. Moreover, there
was a low incidence of pillar and palm pain. In a retrospective review of
patients with a favorable prognosis based on having no need for extra surgical
procedures or additional therapy visits, one therapy visit associated with
improvements in symptoms and function, a low incidence of pillar/palm pain and
favorable 12-weeks outcomes. There appears to be a subset of less complicated
patients for whom one visit can allow for favorable outcomes. LEVEL OF EVIDENCE: 2B.
CI - Copyright (c) 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS