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Dissertation
Consequences of limited palm incision carpal tunnel release: a preliminary study
Doctor of Philosophy (Ph.D.), Allegheny University of the Health Sciences
Dec 1997
DOI:
https://doi.org/10.17918/00009060
Abstract
Carpal tunnel syndrome (CTS) can be treated carpal tunnel release (CTR) surgery, if conservative treatment has failed. Open (OCTR), endoscopic (ECTR) and limited palm (LP-CTR) are the categories of CTR. LP-CTR has not been studied with the rigor as OCTR and ECTR. Studies on CTR have not reported functional performance measures including finger dexterity and dynamic prehension. A within subjects, repeated measures design was used to examine whether LP-CTR use effective. A sample of convenience from one surgeon included 15 adults with CTS, age range 29-72, who underwent LP-CTR to ameliorate symptoms of CTS. Measurements were taken by one investigator within one month before surgery, at 4 to 5 weeks and at 10 to 12 weeks after surgery. Eleven of the 15 patients were also examined 6 to 9 months. Repeated measures or Friedman ANOVA tests revealed significant differences in pillar pressure-pain threshold, dynamic prehension, grip strength, chuck and lateral pinch strengths and patient-reported symptoms and function after LP-CTR. There were significant decreases in grip and pinch strengths and pillar pressure-pain threshold at 4-5 weeks. Symptoms severity decreased significantly from pre-operative to 4-5 weeks. Functional status improved significantly by 10-12 weeks. By 10-12 weeks, grip and pinch had not returned to pre-operative values, but did by 6-9 months. There were no differences in recovery between chuck and lateral pinch strengths. Dynamic prehension was above the pre-operative measure at 10-12 weeks after surgery. There was a positive trend (p >.05) toward improved finger dexterity by 10-12 weeks and continued at 6-9 months after surgery. Spearman correlation coefficients between pillar pain and grip strength and pillar pain and dynamic prehension were significant at 4-5 weeks after surgery, suggesting that pain can contribute to a decrease in physical performance. Reduction in numbness and improvement in dynamic prehension at 6-9 months (r =.67, p <.03), suggested that a decrease in numbness contributes to improvement in dynamic prehension. LP-CTR relieves primary complaints of numbness, tingling and pain in the fingers. Further study is needed to determine if a post-operative physical therapy within the first month after surgery will have an impact on recovery after LP-CTR.
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Details
- Title
- Consequences of limited palm incision carpal tunnel release
- Creators
- Susan L. Michlovitz
- Awarding Institution
- Allegheny University of the Health Sciences
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Allegheny University of the Health Sciences; Philadelphia, Pennsylvania
- Number of pages
- x, 144 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Allegheny University of the Health Sciences (1996-1998); School of Health Professions (1996-1998); Physical Therapy
- Other Identifier
- 991021888911804721