Clinical and radiologic Improvement of Clinical

Slides:



Advertisements
Similar presentations
Carpal Tunnel Syndrome
Advertisements

Wrist & Hand Evaluation
Wrist Orthopaedic Tests
Common Elbow, Wrist, and Hand Problems
Carpal Tunnel Syndrome Presented By NathaëlF Hyppolite RIII MF.
Online Module: Carpal Tunnel Syndrome. Carpal Tunnel Syndrome (CTS) By far the most common entrapment neuropathy, especially of the upper extremity. By.
Carpal Tunnel Syndrome By: Dr. Masoud Shayesteh Azar Associate Professor, Orthopaedic Department, Mazandaran University.
COMMON HAND PROBLEMS RELATED TO WORK
Ms. Bowman.  Articulations: Metacarpophalangeal joints Carpometacarpal joints Intermetacarpal joints Intercarpal joints Radiocarpal joints Distal Radioulnar.
Assessing Abilities and Capacities: Sensation Nisrin Alqatarneh MSc. Occupational therapy Assessment
Carpal Tunnel Syndrome Carpal Tunnel Syndrome Ghada Almeshali AlBandri AlZahid.
Stephanie Shane OTR/L NBCOT Tutor
Second Opinions and Independent Medical Examinations (IMEs)
Carpal tunnel syndrome. Introduction Definition Introduction Definition Carpal tunnel syndrome (CTS) is defined as compression of the median nerve at.
Carpal Tunnel -Surag Khadka. Contents Anatomy Borders and Contents Carpal Tunnel Syndrome Causes Signs and Symptoms Diagnostic tests Management and Treatment.
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome. Definition: It's a compresion of median nerve in the carpal tunnel is called carpal tunnel syndrome.
Tingling Fingers Doug Campbell Consultant Hand Surgeon, Leeds
Wrist/Hand Anatomy Carpals-8 Metacarpals-5 Phalanges - 5 Scaphoid
J. Scott Pritchard, DO 2012 NADE NATIONAL TRAINING CONFERENCE.
Carpal Tunnel Syndrome Angela Whittington. Definition: CTS Median nerve compression Nerve passes under the transverse carpal ligament and through carpal.
The Carpal Tunnel Syndrome For all computer users, please view through and take extra care--- BEWARE!!!!!
Appropriate Indications of Opponensplasty in Carpal Tunnel Syndrome
Carpel Tunnel Syndrome.  Numbness and tingling in thumb, index, and middle fingers  Aching sore hands  Shooting pain which travels to elbow  inability.
Jess Irvin & Kayla Jarrett.  44 y/o, African American, Female  Hairdresser/stylist, Heavy workload  2 weeks s/p CTR on the R UE  Referral to Outpatient.
 Clinical condition where pressure on peripheral nerve produces dysfunction in the nerve.  Carpal Tunnel Syndrome (wrist – median nerve)  Cubital Tunnel.
Adult Trauma: Getting Through the Night by Andrew H. Schmidt, Jeffrey Anglen, Arvind D. Nana, and Thomas F. Varecka J Bone Joint Surg Am Volume 92(2):
Examination of Hands what does it mean & what to do about it. by Don Hudson, D.O.
Upper Limb Orthopaedic update Steven Barnes Inverclyde Royal Hospital.
PERIPHERAL NERVE INJURIES
Final Presentation MMI-402 GROUP #3: William Marella Lena Matternas Rishi Ohri Daniel Runt.
Fractures of the wrist and hand
COMMON ORTHOPAEDIC CONDITIONS OF THE HAND AND WRIST Korsh Jafarnia, MD Methodist Center for Orthopedic Surgery & Sports Medicine.
Pain in the hands. Index Cases Lent term This 67 yr old man comes to you with gradually worsening hand pains. What do you see?
The hand & wrist Band 5 IST 28 th September 2009.
Carpal Tunnel Syndrome. Anatomy Distribution Signs & Symptoms Pain – Worse at night Paraesthesia – Sparing the Thenar Eminence Weakness and Atrophy.
Upper Limb- Blood & nerve supply; effects of nerve injury G.LUFUKUJA1.
A Thesis Presented to the Graduate School Faculty of Medicine, University of Alexandria In partial fulfilment of the requirements of the Master Degree.
Chapter 15 – The Wrist, Hand, and Fingers Pages
Carpal tunnel syndrome is the most common form of compressive neuropathy (direct pressure on the nerve), occurring in approximately 6 to 8 percent of.
Just if you thought you were having a bad day….
The wrist and the hand. Wrist anatomy Radius forms wrist joint with scaphoid, lunate & triquetrum.
Short-term Effect of Radical Hysterectomy with or without Adjuvant Radiation Therapy on Urodynamic Parameters in Patients with Uterine Cervical Cancer.
Presented by: Mary L. Dombovy, MD, MHSA Paul K. Maurer, MD Anthony L. Petraglia, MD Patrick J. Reid, MD Matthew L. Dashnaw, MD, Pharm D M. Gordon Whitbeck,
Hand and Elbow Diagnosis and Initial Management Claire Wright
Carpal Tunnel Syndrome
One-year follow up of a prospective case control study of 60 patients
Reconstruction of fingertip injury by local and regional flaps
Outcome of Primary Cementless Hip arthroplasty in Unstable Intertrochanteric Femur Fracture in Elderlys Su-Hyun Cho, MD., Hyung-Lae Cho, MD., Hong-Cho,
SAT question In this technological age, students are faced with online educational opportunities at both the high school and post-high school levels.
International Neurourology Journal 2016;20:
Waleed Mohamed Amrhassaen Mohammad Salah Abdelaal
Dr. P Bhakta, Dr. S. McGeary, Dr. C. Cody Connolly Hospital, Dublin 15
Fadeel H. Mahmood1, Jeffrey A. Strakowski1,2, Marcie A
Conflict of interests The speaker has the following to disclose related directly or indirectly to the subject of this presentation (period: past three.
Upper Limb Case #1 Table 36 Farah Abbas Jeremy Jacobs Brian McQuillan
Arm injuries Elise McCarthy.
PELVIC OBLIQUITY CONTROL IN CHILDREN WITH NEUROMUSCULAR EARLY ONSET SCOLIOSIS TREATED WITH MAGNETICALLY-CONTROLLED GROWING RODS María del Mar Pozo-Balado,
CHAPTER 21 COMPRESSION NEUROPATHIES
Distraction-to-stall ensures spinal growth in Magnetically Controlled Growing Rods Benny Dahl1), Casper Dragsted2), Søren Ohrt-Nissen2), Thomas Andersen2),
Obada B., Serban Al., Anderlik St., Badauta M., Costea D., Grasa C.
Carpal Tunnel Syndrome
Obada B. , Serban Al. , Borgazi E. , Badauta M. , Botnaru V
RESULTS and DISCUSSION
Nat. Rev. Neurol. doi: /nrneurol
Supplemental method for the reduction of Irreducible Mallet Finger Fractures by Two Extension Block Technique : Dorsal Counterforce Technique Jung Eun.
Complex Transverse Fractures of the Olecranon Treated by the Tension Band Wiring following Absorbable Pin Fixation of Articular Fragment Young Ho Lee.
Kentaro Watanabe, MD, PhD  Journal of Hand Surgery Global Online 
Presentation transcript:

Clinical and radiologic Improvement of Clinical A-0987 Effects of a temperature-sensitive, anti-adhesive agent on the clinical outcome of carpal tunnel release surgery Soo Min Cha, Hyun Dae Shin Chungnam National University School of Medicine, Chungnam National University Hospital, Daejeon, Korea Introduction Clinical items by Graham Preoperative state/ final follow-up Group 1 Group 2 P Numbness or tingling (n) (+) / (+) 6 1 0.08 (+) / (-) 41 49 (-) / (-) Nocturnal numbness (n) 0.23 45 51 2 Thena atrophy (n) 14 9 0.37 4 5 29 37 Tinel (n) 18 0.06 21 34 8 3 Phalen (n) 20 17 0.49 19 13 Improvement of two-point discrimination   (Preoperative TPD – final TPD) Thumb (mm) 0.94±0.82 1.25±1.28 0.14 Index (mm) 1.11±0.91 1.43±0.85 0.07 Long finger (mm) 1.04±1.04 1.37±1.17 Ring finger (mm) 0.86±0.12 1.00±0.75 0.33 We observed a unsatisfactory results after carpal tunnel release surgery. Especially, postoperative adhesions is a major concern in many types of sugery. So, we inject the Guardix-SG®(temporature-sensitive anti adhegisve agent, TSAA) into the intracarpal tunnel space just after TCL. And we evaluated the results radiologically and clinically Methods March 2014 to April 2016, 107 patients were enrolled 53 patients were infused with Guardix and 54 patients were not infused We evaluated six clinical items(numbness or tingling in the median nerve distribution, nocturnal numbness, thenar atrophy, tinel sign, phalen test, loss of two-point discrimination(TPD), and Boston carpal tunnel questionnaire(BCTQ) scores. After accurate reduction of the distal fragment, a cortical screw was inserted in the proximal diaphysis until the maximum compressive force was obtained against the distal fragment. Then, one or two locking screws were added adjacent to the initial cortical screw. No screw fixation was performed in the distal fragment area. Clinical and radiologic outcomes Group 1 Group 2 P Improvement of Clinical (Preoperative scores – final scores) Boston Symptom Scores 17.16 ± 6.41 18.58 ± 3.64 0.19 Boston Function Scores 9.16 ± 4.08 8.93 ± 2.77 0.11 Sonographic measurement at final follow-up (mm) Maximal distance of median Nerve 16.2 ± 8.4 16.4 ± 7.1 0.25 Minimal distance of 12.9 ± 11.6 15.2 ± 8.5 < 0.001 Movements of median Nerve 3.3 ± 1.1 1.2 ± 7.7 * Evaluation of adhesion around median nerve Results Variables Group 1 (Infusion) Group 2 P Age at diagnosis (y) 58.21±10.84 56.75±7.89 0.44 Gender (Male/Female, n) 16:31 9:42 0.07 Onset period of symptoms or signs (mo) 15.30±3.49 15.90±2.48 0.32 The time from the diagnosis to the surgery (mo) 6.72±0.80 6.73±0.72 0.99 Site of the lesion (Dominant/Non-dominant, n) 26:21:00 22:29 0.31 All evaluations were done at least 3 years postoperatively with a mean follow-up of 53.2 months. In adolescents with a closed physis (n=8), the mean radial inclination, volar tilting, and ulna variance were 21.1 ± 1.64°, 11.5 ± 1.07°, and –0.25 ± 0.71 mm, respectively. Conclusion A temperature-senstivie poloxamer/alginate mixture(Guardix-SG®) effectively prevented postoperative neural adhesions as assessed at 18 months during carpal tunnel release However, short term follow-up period results were not a significant clinical difference For more full evaluation the clinical benefits of this treatment, we need further studies with longer follow-up periods. Category (Major SOC2010 groups and example occupations) P   1 2 3 4 5 6 7 8 9 Group 1 (n) 11 13 0.14 Group 2 (n) Bland Scale   P   2 3 4 Group 1 (n) 7 26 14 0.77 Group 2 (n) 9 30 12