AAHS Home  |  2021 Virtual Portal  |  Past & Future Meetings
Countdown to AAHS : 33 Days  
American Association for Hand Surgery

Back to 2022 Abstracts


Clinical Results and Return to Work Following Carpal Tunnel Release with Ultrasound Guidance (CTR-US) Performed in an Office Procedure Room
Matthew J. Kirsch, M.D., Laura Pohl, L.A.T. and Matthew Walters, N.P., Olmsted Medical Center, Rochester, MN

Introduction
Numerous studies have documented the safety and efficacy of CTR-US, but few have reported results of patients treated in office procedure rooms and none have included detailed return to work (RTW) data. The primary purpose of this study was to document the intermediate-term outcomes of CTR-US performed in an office procedure room, including detailed RTW data.
Materials & Methods
All patients treated from 11/2020-6/2021 with pre-operative and at least one post-operative follow-up were included. The same surgeon performed all cases in an office procedure room using only local anesthesia (WALANT), the SX-One MicroKnife, and a single assistant. Data were collected electronically using daily text messages in the early post-operative period followed by emailed questionnaires starting at 2-weeks. Outcomes included complications, intra-operative pain scores (0-10), return to work (RTW), QuickDASH and BCTQ scores, global satisfaction scores (1-5), and "recommend procedure" scores (0-10).
Results
CTR-US was performed on 92 hands in 77 patients ages 29-78 years with BMIs 21-55.8 kg/m2. Over half (53%) had >1 comorbidity, including 9 (12%) with diabetes. Fifteen patients had staged bilateral procedures and 48% of hands released were dominant. The median intra-operative pain score was 0.00 (mean 0.56). No neurovascular injuries or infections occurred. RTW data were recorded for 61/70 hands of patients employed at the time of surgery: 49% (30) returned to work in 1-3 days, 80% (49) within 7 days, and 98% (60) within 14 days. This included 10 hands of patients performing heavy manual jobs, of which 50% (5) RTW in 1-3 days, 90% (9) within 7 days, and 100% (10) within 14 days. Furthermore, 40% (4) returned to full work duties in 1-3 days and 90% (9) within 2 weeks. There were statistically significant reductions in mean QuickDASH and BCTQ scores at 2-weeks, 1-month, 3-months, and 6-months post-CTR (p<0.001, Figure 1). At all post-operative time points the mean global satisfaction score was > 4.67 (4 = satisfied, 5 = very satisfied), and the mean recommendation score was > 9.47 (0-10 with 10 = extremely likely to recommend).
Conclusions
CTR-US using WALANT in an office setting is safe, effective and results in a high degree of patient satisfaction. In this study, most patients returned to work within 7 days post-CTR, including those performing heavy manual labor jobs.


Back to 2022 Abstracts