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Evidence for Ultrasound-Guided Carpal Tunnel Release

  • Sports Medicine Rehabilitation (BJ Krabak and B Liem, Section Editors)
  • Published:
Current Physical Medicine and Rehabilitation Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This report is a narrative review of the clinical evidence for ultrasound (US)-guided carpal tunnel release (USGCTR) in patients with carpal tunnel syndrome (CTS).

Recent Findings

To date, there are 23 clinical publications (case reports, prospective and retrospective case series, and randomized comparative studies) on USGCTR, involving 1,072 wrists. Although many different devices have been used to perform USGCTR, current publications report > 98% clinical success rate without any documented neurovascular injuries. Of the publications, 7 were done by orthopedic surgery, 6 by physiatry, 6 by family medicine, and 1 each by interventional radiology, rheumatology, plastic surgery, and neurosurgery. There is evidence that USGCTR can improve symptom severity, improve functional outcomes, reduce scarring, shorten recovery time, and hasten return to work, even in patients undergoing bilateral release.

Summary

Based on current studies, USGCTR appears to be a safe and effective method for transecting the transverse carpal ligament (TCL), with reported faster recovery and functional improvement than mini-open carpal tunnel release. It is performed by physicians from many different fields of medicine trained in USG procedures. Additional randomized controlled trials, with long-term follow-up, are needed to help to confirm the best device and technique to perform this procedure.

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Abbreviations

BCTQ:

Boston Carpal Tunnel Questionnaire

CSA:

Cross-sectional area

CTR:

Carpal tunnel release

CTS:

Carpal tunnel syndrome

ECTR:

Endoscopic carpal tunnel release

mOCTR:

Mini-open carpal tunnel release

NRS:

Numerical rating scale

OCTR:

Open carpal tunnel release

QDASH:

Quick Disabilities of the Arm Shoulder and Hand questionnaire

SPA:

Superficial palmar arch

TCL:

Transverse carpal ligament

TSZ:

Transverse safe zone

US:

Ultrasound

USGCTR:

Ultrasound-guided carpal tunnel release

VAS:

Visual analog scale

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Wise, A., Pourcho, A.M., Henning, P.T. et al. Evidence for Ultrasound-Guided Carpal Tunnel Release. Curr Phys Med Rehabil Rep 9, 11–22 (2021). https://doi.org/10.1007/s40141-020-00305-0

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