Ultrasound-guided percutaneous carpal tunnel release in patients on hemodialysis: early experiences and clinical outcomes

Figures & data

Figure 1 (A) Instruments for ultrasound-guided percutaneous carpal tunnel release: 18-gauge needle, 10 mL syringe with 21-gauge needle, custom-made blunt probe, custom-made hook knife. (B) Insertion of the 21-gauge needle for lidocaine infiltration and then to create an inlet with an 18-gauge needle. (C) The custom-made blunt probe was inserted subcutaneously to create the correct tract, and the hook knife was introduced to cut the TCL backwardly. (D) The probe was inserted to evaluate adequate release.

Abbreviations: C, capitates; L, lunate; MC, metacarpal; TCL, transverse carpal ligament.

Table 1 Survey scale of symptom improvement after ultrasound-guided percutaneous release

	1 week	1 month	3 months	6 months	12 months	18 months	24 months
Poor	7%	8%	5%	3%	1%	1%	1%
Fair	11%	12%	9%	8%	9%	8%	9%
Good	82%	80%	86%	89%	90%	91%	90%

Table 2 Results of ultrasound-assisted percutaneous release on outcome measurements after surgery

	Baseline	1 week	1 months	3 months	6 months	12 months	18 months	24 months	P-value
Physical exam/telephone*	113/0	109/4	110/3	90/23	101/12	89/24	63/50	41/72
CTS-SSS	3.49±0.87^1	2.45±0.63^2	2.13±0.73^2,3	1.69±0.52^3	1.58±0.13^3	1.36±0.31^4	1.25±0.21^4	1.18±0.13^4	0.05
≥3 (numbness), n (%)**	97(85.8%)	37(32.7%)	24(21.2%)	8(7%)	4(4%)	2(1.7%)	0	0
≥3 (pain), n (%)**	89(78.7%)	13(11.5%)	10(8.8%)	3(2.7%)	2(1.7%)	0	0	0
CTS-FSS	3.73±1.03^1	2.75±1.73^2	2.14±0.81^2	1.76±0.33^2	1.31±0.29^3	1.17±0.13^3	1.09±0.18^3	1.00±0.00^3	0.05

Notes: *Number of patients assessed using a physical examination and face-to-face interview (physical examination) and a telephone interview (telephone). Both interviews used the same questionnaire. **1= no numbness/pain, 2= mild numbness/pain, 3= moderate numbness/pain, 4= severe numbness/pain, 5= very severe numbness/pain. Superscript numbers indicate statistically significant differences across time points by post hoc test.

Abbreviations: CTS-SSS, Carpal Tunnel Syndrome Symptom Severity Score; CTS-FSS, Carpal Tunnel Syndrome Functional Status Score.

Table 3 Results of ultrasound-assisted percutaneous release on sensations and strengths after surgery

	Baseline	1 week	1 month	3 months	6 months	12 months	18 months	24 months	P-value
Physical exam, n	113	109	110	90	101	89	63	41
S2PDS (mm)	9.97±0.73^1	7.38±1.43^2	6.47±1.85^2,3	6.19±1.33^3	6.06±1.78^3	6.17±1.73^3	5.93±0.76^4	5.35±0.62^4	0.05
≥6 mm, % (n)	70.5 (91 of 113)	46.7 (51 of 109)	36.3 (40 of 110)	23.3 (21 of 90)	16.8 (17 of 101)	20.2 (18 of 89)	11.1 (7 of 63)	4.9 (2 of 41)
SW monofilament (mm)	5.17±0.67^1	4.61±0.73^1	4.17±0.77^2	3.96±0.79^2	3.81±0.75^2	3.67±0.71^2	3.27±0.67^3	3.14±0.87^3	0.05
Grip power (kg)	15.17±14.3^1	5.03±4.6^2	11.71±10.9^3	13.35±11.2^1,3	16.79±9.5^4	17.13±10.8^4	16.01±10.9^4	17.11±10.6^4	0.05
Three-jaw chuck pinch (kg)	4.87±2.1^1	3.12±3.4^1	6.10±2.7^2	6.12±3.1^2	7.14±3.2^3	8.19±3.1^4	8.03±3.4^4	9.98±3.6^4	0.05

Notes: Data presented as means ± SD unless otherwise indicated. Superscript numbers indicate statistically significant differences across time points by post hoc test.

Abbreviations: S2PDS, static two-point discrimination test; SW, Semmes–Weinstein.