Document Detail


Optimal management of carpal tunnel syndrome.
MedLine Citation:
PMID:  20830201     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
In order to improve health care efficiency and effectiveness, treatments should provide disease improvement or resolution at a reasonable cost. The American Academy of Orthopedic Surgeons (AAOS) published a guideline for treatment of carpal tunnel syndrome (CTS) in 2009 based on review of the literature up to April 6, 2007. We have now reviewed the material published since then. Through reviewing evidence-based articles published during this period, this paper examines the current options and trends for treating CTS. We performed a systematic review of the randomized controlled trials, meta-analyses, systematic reviews, and practice guidelines to present the outcomes of current treatments for this disease. Twenty-five studies met our inclusion criteria. Thirteen randomized, controlled trials and 12 systematic reviews, including three Cochrane database systematic reviews, were retrieved. Our review revealed that most of the recent studies support the AAOS guideline. However, the recent literature demonstrates a trend towards recommending early surgery for CTS cases with or without median nerve denervation, although the AAOS guideline recommends early surgical treatment only for cases with denervation. The usefulness of splinting and steroids as initial treatments for improving patients' symptoms are also supported by the recent literature, but these effects are temporary. The evidence level for ultrasound treatment is still low, and further studies are needed to determine the effectiveness of this treatment. Finally, our review revealed a paucity of articles comparing the costs of CTS diagnosis and treatment. With the recent focus on health care reform and rising costs, attention to the direct and indirect costs of health care is important for all conditions. Future well designed studies should include cost analyses to help determine the cost burden of CTS.
Authors:
Shimpei Ono; Philip J Clapham; Kevin C Chung
Publication Detail:
Type:  Journal Article     Date:  2010-08-30
Journal Detail:
Title:  International journal of general medicine     Volume:  3     ISSN:  1178-7074     ISO Abbreviation:  Int J Gen Med     Publication Date:  2010  
Date Detail:
Created Date:  2010-09-10     Completed Date:  2011-07-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101515487     Medline TA:  Int J Gen Med     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  255-61     Citation Subset:  -    
Affiliation:
Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA.
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MeSH Terms
Descriptor/Qualifier:
Grant Support
ID/Acronym/Agency:
K24 AR053120-04/AR/NIAMS NIH HHS; K24 AR053120-05/AR/NIAMS NIH HHS

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