Carpal Tunnel Surgery

Based on the progress report dated 10/07/16, the patient presents for evaluation of carpal tunnel syndrome on the right shoulder.

DOI: 9/30/2014. Patient is a 28-year-old female research assistant who alleges pain and weakness in her hands/wrist as a result of repetitive scooping dirt from soil barrels. As per OMNI entry, the patient was diagnosed with cervicobrachial syndrome (diffuse), right carpal tunnel syndrome and insomnia. She is status post endoscopic carpal tunnel release (CTR) on 09/24/2015 for the right and on 06/02/2015 for the left side.

If you suspect you or someone you know is showing symptoms of Carpal Tunnel, we advise you see a

Electromyography report dated 01/05/2016 (no official report) revealed mild carpal tunnel syndrome on the right and moderate on the left.

The patient is a 48-year-old individual who sustained an injury on 09/20/16. During that time, he was running food on a plastic tray plate at work when the plates suddenly jammed to his left hand.

DOI: 11/17/2015. Patient is a year old male mechanic who sustained injury while he was throwing a broken urinal into dumpster when it broke and cut his left wrist. Per OMNI, he was initially diagnosed with laceration to left wrist/forearm flexor tendons to middle, ring and pinky fingers. Surgery was done on 11/25/15 for left forearm repair.

The status of this case is that we are awaiting the applicant to undergo an EMG of the upper extremity as recommended by the Panel Qualified Medical Evaluator, Dr. Stephan Choi, in his evaluation report dated December 14, 2016. Please recall, Dr. Choi requested an EMG of the right upper extremity so he can rule out possible carpal tunnel release. He opined if the EMG of the right upper extremity were to come back normal, the applicant would be deemed permanent and stationary.

This is a 46-year-old female with a 10/10/2012 date of injury, due to a cumulative trauma to the neck, right shoulder, right wrist and hand.

Carpal Tunnel syndrome (CTS). The rationale for choosing CTS as the most likely differential diagnosis is based on the subjective, objective data and T.R occupation. Evidence: CTS are caused by excessive used and repetitive movements of the wrist, which cause a loss of space and impingement of the median nerve. A type of activity that is associated with CTS, is computer use (Goolsby & Grubbs, 2011). CTS is a common musculoskeletal disorder affects approximately 1.5% to 2.8% Americans. The yearly costs estimated at $2 billion. The most common involve joints are the first (thumb), second (index finger), third (middle finger), and fourth (ring finger) metacarpophalangeal. CTS symptoms include: tingling, numbness, burning, or pain usually affects the anterior part of the wrist, medial palm and the first three digits on the hand (Thiese, Gerr, Hegmann, Harris-Adamson, Dale, Evanoff, & Rempel, 2014).

Symptoms of CTS include tingling and numbness of the hands and fingers focusing primarily in the thumb and the Index fingers. Patients tend to experience feelings of swelling in the hand when no visual symptom is shown. In the beginning of the disease the symptoms tend to be experienced during the night and slowly progress to be experienced during the day. The feeling of having to shake

On 01/03/2018, the claimant presented for a follow-up for the right wrist. She complained of pain and weakness in her right wrist/hand. The associated symptoms include joint pain, joint stiffness, weakness, pain, and decreased strength. Objective findings showed healed pin sites. There was less swelling, deformity, tenderness, and limited range of motion. She had a full range of motion in the fingers with popping in the wrist. She lacked full supination and pronation. Physical therapy was

An article by Aslani et al., “Comparison of carpal tunnel release with three different techniques” compared the open release, endoscopic release and mid-palmar release. It was a clinical trial study that was done over a period of one year on patients who were surgical candidates for carpal tunnel syndrome (Aslani et al., 2012). Patients were diagnosed based on clinical symptoms and electro-diagnostic studies (Aslani et al., 2012). The clinical diagnosis was made based on the presence of three or more of the following: history of recurrent or persistence paresthesias in the median nerve distribution, nocturnal awaking with paresthesia, worsening of symptoms with any hand activity, positive Tinel’s and Phalen’s sign on physical exam (Aslani et al., 2012). Total of 105 patients were diagnosed and were studied over a course of one year (Aslani et al., 2012). Patients who entered the study had not responded to non-surgical treatments for 6 months (Aslani et al., 2012).

HISTORY OF PRESENT ILLNESS: Brandon is a right hand dominant trailer manufacture worker who has been off work since his injury, who injured his right dominant hand seven weeks ago when he caught it between a heavy TV set he was carrying at home and the wall, sustaining a painful deformity of the right hand. That treatment consisted of a closed reduction of the fourth and fifth metacarpal bases done by Jake Heiney, MD. The patient had a benign post-operative course and was recovering uneventfully. His records were reviewed for this visit. He reports no complaints of pain or swelling. No neurovascular or muscular changes. He feels much better overall. No pain at all with most activity. Occasionally sore when he has used it a lot.

Due to a schedule conflict my co-worker Chris Callahan attended the appointment with Mr. Price and Dr. Werner on 6/15/16. Mr. Price said that he has difficulty gripping with the right hand. He also reports numbness and tingling to the first three fingers. He stated this has been consistent since the injury. Dr. Werner reviewed the EMG report. Grip test showed that his right hand is weaker than the left. Dr. Werner did tapping and repositioning of the hands and wrist which resulted in numbness to the first four fingers of the right hand. Tapping to the elbow also caused the fifth finger to go numb. Ms. Callahan asked for clarification on the cause of the Carpal Tunnel (CTS) diagnosis. Dr. Werner stated that changes in the right shoulder

Problems and recovery of post-operative patients with carpal tunnel syndrome: a thematic analysis of Internet forum comments