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Theme: Inclusion and Collaboration Theme: Inclusion and Collaboration

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Ultrasound Guided Carpal Tunnel Release Using A Novel Device: Early Clinical Results
Troy Henning, DO; Paul Paterson, MD; Tyson Cobb, MD
Genesis Health System, Davenport, IA

Introduction

Over 600 cases of ultrasound guided carpal tunnel release (UGCTR) have been reported in the peer-reviewed literature without complication and with excellent efficacy. Nonetheless, concerns with respect to safety and technical difficulty may prevent more widespread adoption of this promising technique. The purpose of this study is to present the early clinical results following UGCTR using the SX-One MicroKnife, a novel, commercially available device with integrated safety and usability features.

Materials & Methods

UGCTR was performed on 28 patients (38 wrists) ages 42-90, including 3 patients (5 wrists) who were crutch or wheelchair dependent. All procedures were performed by a physiatrist (22 wrists) or two fellowship trained orthopedic hand surgeons (16 wrists) in three different practices using the SX-One MicroKnife, which allows single-handed operation and dynamically expands the safe zone within the carpal tunnel through the use of inflatable balloons. Seventeen of 38 wrists were released in an outpatient clinical setting using local anesthesia only and 21 in the operating room under sedation. Primary outcomes included complications, Boston Carpal Tunnel Questionnaire (BCTQ) and QuickDash scores, and global satisfaction (1 = very dissatisfied, 2 = dissatisfied, 3 = neither satisfied nor dissatisfied, 4 = satisfied, 5 = very satisfied). One-month data were available at the time of abstract submission, and longer-term results are being prospectively collected.

Results

UGCTR was successfully completed on all 38 wrists without complication, including 10 simultaneous bilateral releases. No procedures required conversion to an alternative technique and patients were allowed to resume normal activities as tolerated, including immediate crutch and wheelchair use. At 1-month follow-up (28 patients/38 wrists) no complications had occurred and mean patient reported outcomes were global satisfaction 4.1, BCTQ-Symptom Severity 1.4, BCTQ-Function 1.3 and QuickDash 14.7. Mean improvements in pre versus 1-month BCTQ-Symptom Severity, BCTQ-Function and QuickDash scores (21 patients/29 wrists) were 1.12, 0.94 and 28.9 respectively.

Conclusion

Early clinical results indicate that UGCTR using the SX-One MicroKnife can be performed safely and effectively in a variety of practice settings and may facilitate faster recovery following carpal tunnel release. Longer-term follow-up on this patient group is in progress and further clinical experience using the SX-One MicroKnife is being accumulated.


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