Endoscopic Cubital Tunnel Release

Size: px
Start display at page:

Download "Endoscopic Cubital Tunnel Release"

Transcription

1 Endoscopic Cubital Tunnel Release Cobb TK, Walden AL, Lemke JH, Merrell PT. Setting expectations following endoscopic cubital tunnel release. HAND. April DOI /s

2 Cubital Tunnel Syndrome: Minimally Invasive Treatment Endoscopic cubital tunnel release Old Anterior Nerve Transposition 2

3 Endoscopic Cubital Tunnel Surgery

4 Setting Expectations following Endoscopic Cubital Tunnel Release Cobb TK, Walden AL, Lemke JH, Merrell PT. Setting expectations following endoscopic cubital tunnel release. HAND. April DOI /s

5 Cubital Tunnel Syndrome: Studies - Results Setting Expectations following Endoscopic Cubital Tunnel Release 1/2 of endoscopic release pts returned to work in 1 week Open release pts returned to work in 2 months Improvement in preoperative signs/symptoms Signs/symptoms Pre-op % Resolution Numbness/tingling 94% 79% Pain 55% 81% Weakness 44% 86% Abnormal 2 pt 28% 76% Atrophy 27% 78% Wartenberg s 15% 65% Cobb, Walden, Lemke, and Merrell. HAND. April

6 Number of Days Cubital Tunnel: Return to Work ECTR Open Modifed Work Regular Work 6

7 Time off work Cubital Tunnel Syndrome: Studies - Clinical Significance Operative costs Endoscopic benefit Difference in tourniquet time (49 min) Cubital tunnel surgeries per Endoscopic 10 min vs open 59 min year = 73,673 Cost of OR time Return to work 63 days Total sooner Estimated $29 per minute with endoscopic procedure Cost savings Cost savings Annual Savings for 49 min x $29/min = $1,421 per pt Daily cost of disability = $94 x 73,673 cases = $72,199,540 per year $94 (per day) x 63 days (RTW) U.S. = $5,922 per patient Anesthesia costs x 73,673 cases = = $520 million Billed Base Rate of $65 per 15 min block over $436 million per year Approx 45 min less time (3 blocks) $65/block x 3 = $195 per pt x 73,673 cases = $14,366,235 per year Davis et. al Issue Brief Common Fund 2005; CDC Sept. 18, 2013; Macario A J Clini Anesth

8 Prospective Multicenter Evaluation of Endoscopic Cubital Tunnel Release Tyson Cobb, Blain Samuelson, Jon Lemke, Anna Cobb, Steven Topper

9 Methods 230 cases (Females=107, Males=123) 211 patients 4 Private Orthopaedic Practices Miami, FL Davenport, IA Denver, CO Owings Mills, MD

10 Patients (n) Patients (n) Demographics Site Total (%) Male (%) Female (%) IA 125 (54) 78 (62) 47 (38) MD 70 (31) 32 (46) 38 (54) CO 19 (9) 4 (21) 15 (79) FL 16 (7) 9 (56) 7 (44) Total (53) 107 (47) Number of Patients by Site IA MD CO FL Working rank Count (%) 1-mild 131 (58) 2-moderate 13 (6) 3-heavy 22 (10) 4-unemployed 61 (27) Number of Patients by Rank

11 Pre Op Data by Site Compile all 4 sites or analyze each separately? Dellon s IA MD CO FL Total 1-mild 25 (20) 12 (17) 5 (26) 2 (13) 44 (19) 2-moderate 45 (36) 28 (40) 12 (63) 10 (63) 95 (41) 3-severe 55 (44) 30 (43) 2 (11) 4 (25) 91 (40) Total *Parentheses show percentage of Dellon s classification by each site

12 Amount of Time for Surgery (minutes) Site Mean Std. Dev. Median Min Max IA MD CO FL

13 Pre Op vs. Intra Op Subluxation Measure: Clinical Observation -Pre Op Intra Op Subluxation (truth) No Yes Total No Yes Total False Negative: 7 of 204 = 3% 95% CI: ( ) False Positive: 12 of 15 = 80% 95% CI: ( ) Specificity: 197 of 209 = 94% 95% CI: ( ) Sensitivity: 3 of 10 = 30% 95% CI: ( )

14 Using Final Follow Up Final Follow Up range Longest was almost 5 years Shortest was one week Issue of Final Follow up vs. First Resolution Rate of resolution differences (pain, NT, weakness, etc.) Issue with this type of surgery-easy to hit Not due to surgery not lasting, just due to how frequently you can hit this nerve

15 First Follow Up Dates Site N Mean Median Min Max IA MD CO FL Can t determine rate of resolution until you have at least your first follow up. These significantly increase your days to resolution data

16 Resolution of Symptoms Site Numbness and Tingling Positive Pre-Op Test Resolution Time to Resolution N (%) N (%) Median Days IA 113 (53) 96 (85) 30 MD 68 (32) 40 (59) 381 CO 17 (8) 12 (71) 67 FL 15 (7) 11 (73) 145 Total 213 (93) 159 (75) 90

17

18 Dellon s Class Numbness and Tingling Positive Pre-Op Test Resolution Time to Resolution N (%) N (%) Median Days 1 34 (16) 30 (88) (40) 63 (73) (42) 62 (70) 159 No Score 4 (2) 4 (100) - Total 213 (93) 159 (75) 90 Operated Hand Numbness and Tingling Positive Pre-Op Test Resolution Time to Resolution N (%) N (%) Median Days Dominant 96 (45) 78 (81) 46 Nondominant 108 (51) 73 (68) 136 Undetermined 9 (4) 8 (89) 1184 Total 213 (93) 159 (75) 90

19 Resolution of Symptoms Site Positive Pre-Op Test Pain Resolution Time to Resolution N (%) N (%) Median Days IA 54 (44) 52 (96) 15 MD 46 (37) 38 (83) 39 CO 11 (9) 11 (100) 82 FL 13 (10) 11 (85) 89 Total 124 (54) 112 (90) 31

20

21 Satisfaction by Dellon s Class Satisfaction n (%) Dellon's Class Very Dissatisfied Very Satisfied mild 0 1 (3) 3 (9) 7 (21) 22 (67) 2 - moderate 2 (3) 2 (3) 7 (10) 21 (30) 39 (55) 3 - severe 1 (1) 4 (5) 21 (24) 18 (21) 42 (49) Total 3 (2) 7 (4) 31 (16) 46 (24) 103 (54)

22 Pre-Op Dellon s Class vs. Post-Op Bishop s Pre Dellon's Class Poor 0 to 2 Post Bishop's Ranking Fair 3 to 4 Good 5 to 7 Excellent 8 to 9 Total 1 - mild (21) 27 (79) moderate 0 1 (1) 19 (27) 51 (72) severe 3 (4) 6 (7) 21 (25) 55 (65) 85 Total 3 (2) 7 (4) 47 (25) 133 (70) 190

23

24 Days to Return to Work Normal By Site

25 Work Comp on RTW Work Comp N Mean Median Std. Dev. IQR No Yes P value: 0.050

26 Summary Differences in Pre Op Data Who they perform the surgery on Dellon s, sex, working rank Learning Curve of the surgery Time in surgery Changes in sample population Incomplete data; due to lack of follow up or phone call Final Follow Up issues Long time, easy to re-injure, lower post op scores Work Comp on RTW

27 Thank you! Questions?

Setting expectations following endoscopic cubital tunnel release

Setting expectations following endoscopic cubital tunnel release DOI 10.1007/s11552-014-9629-7 Setting expectations following endoscopic cubital tunnel release Tyson K. Cobb & Anna L. Walden & Peter T. Merrell & Jon H. Lemke # The Author(s) 2014. This article is published

More information

Endoscopic Cubital Tunnel Recurrence Rates

Endoscopic Cubital Tunnel Recurrence Rates HAND (2010) 5:179 183 DOI 10.1007/s11552-009-9227-2 ORIGINAL ARTICLE Endoscopic Cubital Tunnel Recurrence Rates Tyson K. Cobb & Patrick T. Sterbank & Jon H. Lemke Received: 9 February 2009 / Accepted:

More information

What Treatment Works, What Does Not, When Is ENOUGH Enough?

What Treatment Works, What Does Not, When Is ENOUGH Enough? What Treatment Works, What Does Not, When Is ENOUGH Enough? Hand And Elbow Injuries Dori Cage, M.D. Goals of Talk Provide cases to stimulate discussion Present an approach when considering further surgery

More information

Carpal Tunnel Syndrome & Thread Carpal Tunnel Release (TCTR) The Guo Technique. Minimally Invasive Procedure for CTR. Danzhu Guo, MD 10.4.

Carpal Tunnel Syndrome & Thread Carpal Tunnel Release (TCTR) The Guo Technique. Minimally Invasive Procedure for CTR. Danzhu Guo, MD 10.4. Carpal Tunnel Syndrome & Thread Carpal Tunnel Release (TCTR) The Guo Technique Minimally Invasive Procedure for CTR Danzhu Guo, MD 10.4.18 CTS has the longest average disability duration among the top

More information

PG Session: Power Ortho: Hand & Wrist/ Kyle Bickel, MD, FACS

PG Session: Power Ortho: Hand & Wrist/ Kyle Bickel, MD, FACS WOHC 2012 Hand & Wrist Kyle D. Bickel, M.D., FACS The Hand Center of San Francisco Disclosure Information Western Occupational Health Conference 2012 Kyle D. Bickel, MD, FACS I have no pertinent financial

More information

Cubital Tunnel Syndrome

Cubital Tunnel Syndrome Cubital Tunnel 2 3333 N CALVERT ST, SUITE 370, BALTIMORE, MD 21218 T410 467 5400 F410 366 9826 delloninstitutes.com your complaints are Numbness or tingling in the little/ring side of the front and back

More information

Disclosure. Carpal Tunnel Syndrome 11/9/15

Disclosure. Carpal Tunnel Syndrome 11/9/15 Michael S. Bednar, M.D. Chief, Hand Surgery Professor, Dept of Orthopaedic Surgery and Rehab Loyola University - Chicago Disclosure No conflicts for this talk Carpal Tunnel Syndrome AKA Corporal tunnel

More information

Nerve Compression Syndromes Median Nerve Carpal Tunnel Syndrome Pronator Syndrome Ulnar Nerve Cubital Tunnel Syndrome Ulnar Tunnel Syndrome TOS www.fisiokinesiterapia.biz Carpal Tunnel Syndrome (CTS) Definition

More information

Carpal Tunnel Syndrome/ Cubital Tunnel Syndrome. Nerve anatomy. Pathophysiology 6/14/2014. Most common compression neuropathies of the upper extremity

Carpal Tunnel Syndrome/ Cubital Tunnel Syndrome. Nerve anatomy. Pathophysiology 6/14/2014. Most common compression neuropathies of the upper extremity Carpal Tunnel Syndrome/ Cubital Tunnel Syndrome Justin Arnold MD Family Medicine Update 2014 Most common compression neuropathies of the upper extremity Increasing prevalence CTS 50/1000 subjects Up to

More information

Cubital tunnel syndrome: Simple decompression versus decompression and anterior subcutaneous transposition

Cubital tunnel syndrome: Simple decompression versus decompression and anterior subcutaneous transposition CLINICAL ARTICLE SA ORTHOPAEDIC JOURNAL Autumn 2009 / Page 43 C LINICAL A RTICLE Cubital tunnel syndrome: Simple versus and anterior subcutaneous Y Ramguthy BMedSc(UDW), MBChB (Medunsa) Orthopaedic Registrar*

More information

Clinical Study Our Early Experience in Surgical and Clinical Outcome on Endoscopic Cubital Tunnel Release: A Preliminary Result

Clinical Study Our Early Experience in Surgical and Clinical Outcome on Endoscopic Cubital Tunnel Release: A Preliminary Result International Scholarly Research Network ISRN Orthopedics Volume 2011, Article ID 427403, 5 pages doi:10.5402/2011/427403 Clinical Study Our Early Experience in Surgical and Clinical Outcome on Endoscopic

More information

Jay Smith, M.D. Chief Medical Officer and Founder, Sonex Health LLC March 2018

Jay Smith, M.D. Chief Medical Officer and Founder, Sonex Health LLC March 2018 SX-One MicroKnife Ultrasound Guided Carpal Tunnel Release: Initial Clinical Experience Jay Smith, M.D. Chief Medical Officer and Founder, Sonex Health LLC March 2018 Introduction Carpal tunnel syndrome

More information

Cubital Tunnel Syndrome

Cubital Tunnel Syndrome Cubital Tunnel 2 D E L L O N I N S T I T U T E S F O R P E R I P H E R A L N E R V E S U R G E R Y 1122 KENILWORTH DRIVE, SUITE 18, TOWSON, MARYLAND 21204 T410 337 5400 F410 337 5520 dellon.com Right hand

More information

Initial experience with endoscopic carpal tunnel release surgery

Initial experience with endoscopic carpal tunnel release surgery Initial experience with endoscopic carpal tunnel release surgery Craig H. Rabb, M.D., and Todd Kuether, M.D. Division of Neurosurgery, Oregon Health Sciences University, Portland, Oregon; and Portland

More information

Inspection. Physical Examination of the Elbow. Anterior Elbow 2/14/2017. Inspection. Carrying angle. Lateral dimple. Physical Exam of the Elbow

Inspection. Physical Examination of the Elbow. Anterior Elbow 2/14/2017. Inspection. Carrying angle. Lateral dimple. Physical Exam of the Elbow of the Elbow Anthony A. Romeo, MD Professor, Department of Orthopedics Head, Section of Shoulder and Elbow Surgery Rush University President-Elect, American Shoulder Elbow Surgeons Team Physician, Chicago

More information

EndoRelease ENDOSCOPIC CUBITAL TUNNEL RELEASE SYSTEM

EndoRelease ENDOSCOPIC CUBITAL TUNNEL RELEASE SYSTEM EndoRelease ENDOSCOPIC CUBITAL TUNNEL RELEASE SYSTEM SURGICAL TECHNIQUE Up p e r Ex t r e m i t y So l u t i o n s ENDOSCOPIC CUBITAL TUNNEL RELEASE SYSTEM Description: The EndoRelease Endoscopic Cubital

More information

Endoscopic versus open carpal tunnel release: a cost-effectiveness analysis Chung R C, Walters M R, Greenfield M L, Chernew M E

Endoscopic versus open carpal tunnel release: a cost-effectiveness analysis Chung R C, Walters M R, Greenfield M L, Chernew M E Endoscopic versus open carpal tunnel release: a cost-effectiveness analysis Chung R C, Walters M R, Greenfield M L, Chernew M E Record Status This is a critical abstract of an economic evaluation that

More information

Carpal tunnel decompression (under local anaesthesia)

Carpal tunnel decompression (under local anaesthesia) Carpal tunnel decompression (under local anaesthesia) Turnberg Building Orthopaedics 0161 206 4898 All Rights Reserved 2017. Document for issue as handout. Procedure The carpal tunnel is a tunnel found

More information

About Dr. Tyson Cobb, Director of Hand and Upper Extremity Center

About Dr. Tyson Cobb, Director of Hand and Upper Extremity Center About Dr. Tyson Cobb, Director of Hand and Upper Extremity Center Dr. Tyson Cobb, a pioneer in the use of minimally invasive orthopedic surgery, graduated from Texas Tech School of Medicine. While serving

More information

SWESPINE THE SWEDISH SPINE REGISTER 2010 REPORT

SWESPINE THE SWEDISH SPINE REGISTER 2010 REPORT SWESPINE THE SWEDISH SPINE REGISTER 21 REPORT SEPTEMBER 21 SWEDISH SOCIETY OF SPINAL SURGEONS Björn Strömqvist Peter Fritzell Olle Hägg Bo Jönsson ISBN 978-91-978553-8-9 Table of Contents 2 Introduction

More information

Common Upper Extremity Neuropathies (Not Carpal Tunnel Syndrome)

Common Upper Extremity Neuropathies (Not Carpal Tunnel Syndrome) Common Upper Extremity Neuropathies (Not Carpal Tunnel Syndrome) Nerve Compressions Common in adults, rare in children Frequently cause missed days of work and sleepless nights CDC 2001 26,794 cases of

More information

OCCUPATIONAL HAND INJURIES: Impacts on Impairments and Disability

OCCUPATIONAL HAND INJURIES: Impacts on Impairments and Disability OCCUPATIONAL HAND INJURIES: Impacts on Impairments and Disability Anthony Mollano MD Specializing in Hand, Wrist, and Elbow Surgery Concord Orthopaedics, Concord, NH BACKGROUND -Eight years in practice

More information

CUBITAL TUNNEL SYNDROME: REVIEW OF 14 ANTERIOR SUBCUTANEOUS TRANSPOSITIONS OF THE VASCULARIZED ULNAR NERVE

CUBITAL TUNNEL SYNDROME: REVIEW OF 14 ANTERIOR SUBCUTANEOUS TRANSPOSITIONS OF THE VASCULARIZED ULNAR NERVE CUBITAL TUNNEL SYNDROME: REVIEW OF 14 ANTERIOR SUBCUTANEOUS TRANSPOSITIONS OF THE VASCULARIZED ULNAR NERVE M. Farzan *, S. M. J. Mortazavi and S. Asadollahi Department of Orthopedic Surgery, Imam Khomeini

More information

Debridement arthroplasty for osteoarthritis of the elbow (Outerbridge-Kashiwagi procedure)

Debridement arthroplasty for osteoarthritis of the elbow (Outerbridge-Kashiwagi procedure) Acta Orthop. Belg., 2004, 70, 306-310 ORIGINAL STUDIES Debridement arthroplasty for osteoarthritis of the elbow (Outerbridge-Kashiwagi procedure) Bart VINGERHOEDS, Ilse DEGREEF, Luc DE SMET From the University

More information

Carpal Tunnel Release

Carpal Tunnel Release Carpal Tunnel Release Carpal tunnel syndrome is a condition in the hand and wrist caused by excessive pressure on the median nerve in the wrist. Compression of the nerve typically causes numbness and tingling

More information

Name Date. Date of Birth Social Security #: Street Address. City State Zip. Home Phone Cell Phone Address. Employer Business Phone

Name Date. Date of Birth Social Security #: Street Address. City State Zip. Home Phone Cell Phone  Address. Employer Business Phone Barcode Label Interviewer: Office: **PLEASE USE BLACK INK** Patient Information Please Print Name Date Date of Birth Social Security #: Street Address City State Zip Home Phone Cell Phone E-Mail Address

More information

A Staged Approach to Analgesia After Hip Arthroscopy Using Multimodal Analgesia & Elective Ultrasound Guided Fascia Iliaca Block

A Staged Approach to Analgesia After Hip Arthroscopy Using Multimodal Analgesia & Elective Ultrasound Guided Fascia Iliaca Block A Staged Approach to Analgesia After Hip Arthroscopy Using Multimodal Analgesia & Elective Ultrasound Guided Fascia Iliaca Block James T. Beckmann MD Stephen K. Aoki MD Stephen Guyette MD Jeffrey Swenson

More information

Cubital Tunnel release

Cubital Tunnel release Cubital Tunnel release Information for patients Nottingham Shoulder and Elbow Unit This document can be provided in different languages and formats. For more information please contact: Physiotherapy Department

More information

Musculofascial lengthening for the treatment of patients with medial epicondylitis and coexistent ulnar neuropathy

Musculofascial lengthening for the treatment of patients with medial epicondylitis and coexistent ulnar neuropathy Musculofascial lengthening for the treatment of patients with medial epicondylitis and coexistent ulnar neuropathy H. S. Gong, M. S. Chung, E. S. Kang, J. H. Oh, Y. H. Lee, G. H. Baek From Seoul National

More information

A Patient s Guide to Ulnar Nerve Entrapment at the Wrist (Guyon s Canal Syndrome)

A Patient s Guide to Ulnar Nerve Entrapment at the Wrist (Guyon s Canal Syndrome) A Patient s Guide to Ulnar Nerve Entrapment at the Wrist (Guyon s Canal Syndrome) Introduction The ulnar nerve is often called the funny bone at the elbow. However, there is little funny about injury to

More information

Fusion and repeat discectomy following single level open lumbar discectomies. Survival analysis

Fusion and repeat discectomy following single level open lumbar discectomies. Survival analysis Fusion and repeat discectomy following single level open lumbar discectomies. Survival analysis Dr John Mortimer Mr Chris Hoffman CCDHB and TBI Health group Sciatica = Leg Dominant Pain Patients referred

More information

Cubital Tunnel release

Cubital Tunnel release Cubital Tunnel release Information for patients Nottingham Shoulder and Elbow Unit This document can be provided in different languages and formats. For more information please contact: Physiotherapy Department

More information

Primary Chiropractic and Physical Therapy Soft Tissue Treatment Guidelines

Primary Chiropractic and Physical Therapy Soft Tissue Treatment Guidelines Primary Chiropractic and Physical Therapy Soft Tissue Treatment Guidelines 1. Preface The WCB Health Services Unit developed these guidelines for soft tissue injuries, with input from biomechanical health

More information

Interlaminar Decompression & Stabilization. Reginald Davis, M.D., FAANS, FACS Director of Clinical Research

Interlaminar Decompression & Stabilization. Reginald Davis, M.D., FAANS, FACS Director of Clinical Research Interlaminar Decompression & Stabilization Reginald Davis, M.D., FAANS, FACS Director of Clinical Research Disclosures Background Device meant to stabilize the spine without fusion following decompression

More information

The Maloney Nerve Institute Christopher T. Maloney, Jr., M.D North Swan Road Tucson, AZ Phone: (520) Fax: (520)

The Maloney Nerve Institute Christopher T. Maloney, Jr., M.D North Swan Road Tucson, AZ Phone: (520) Fax: (520) Christopher T. Maloney, Jr., M.D., is a Harvard trained plastic surgeon and a Diplomate of the American Board of Plastic Surgeons and a Member of the American Society for Plastic Surgery, a select group

More information

CARPAL TUNNEL RELEASE

CARPAL TUNNEL RELEASE CARPAL TUNNEL RELEASE Relieving Pressure in Your Wrist What Is Carpal Tunnel Syndrome? Carpal tunnel syndrome (CTS) is a condition that affects nerves in the wrist and hand. CTS causes tingling and numbness

More information

Ulnar Nerve : What Should I Do? Disclosure. Cubital Tunnel Syndrome 9/9/2018. I have nothing to disclose

Ulnar Nerve : What Should I Do? Disclosure. Cubital Tunnel Syndrome 9/9/2018. I have nothing to disclose Ulnar Nerve : What Should I Do? John J. Fernandez, MD, FAAOS Assistant Professor Orthopaedic Surgery Hand & Microvascular Surgery Rush-Presbyterian-St. Luke s Medical Center Disclosure I have nothing to

More information

NHS Fylde and Wyre Clinical Commissioning Group. Policies for the Commissioning of Healthcare. Policy for surgical treatment of carpal tunnel syndrome

NHS Fylde and Wyre Clinical Commissioning Group. Policies for the Commissioning of Healthcare. Policy for surgical treatment of carpal tunnel syndrome NHS Fylde and Wyre Clinical Commissioning Group Policies for the Commissioning of Healthcare Policy for surgical treatment of carpal tunnel syndrome 1 Introduction 1.1 This document is part of a suite

More information

Arch Repair with the Bolton Medical RelayBranch Thoracic Stent-graft system: Multicenter experience

Arch Repair with the Bolton Medical RelayBranch Thoracic Stent-graft system: Multicenter experience Arch Repair with the Bolton Medical RelayBranch Thoracic Stent-graft system: Multicenter experience Joost van Herwaarden, MD, PhD University Medical Center, Utrecht Disclosure I have the following potential

More information

No Disclosures. The University of Michigan Rotator Cuff Registry: Lessons we have learned WHY I CHOSE TO STUDY ROTATOR CUFF DISEASE

No Disclosures. The University of Michigan Rotator Cuff Registry: Lessons we have learned WHY I CHOSE TO STUDY ROTATOR CUFF DISEASE The University of Michigan Rotator Cuff Registry: Lessons we have learned Bruce S. Miller, MD, MS Department of Orthopaedic Surgery, University of Michigan No Disclosures WHY I CHOSE TO STUDY ROTATOR CUFF

More information

SUMMER REGISTRATION SATISFACTION SURVEY 2010

SUMMER REGISTRATION SATISFACTION SURVEY 2010 SUMMER REGISTRATION SATISFACTION SURVEY 2010 Did you register during one of the "group" registration days (June 4 or 5; July 8 or 9)? Frequency Valid Valid No 53 15.9 15.9 15.9 Yes 280 84.1 84.1 100.0

More information

There is substantial variation in

There is substantial variation in Clin Orthop Relat Res (2016) 474:1770 1774 / DOI 10.1007/s11999-015-4183-3 Clinical Orthopaedics and Related Research A Publication of The Association of Bone and Joint Surgeons Published online: 18 February

More information

Patient Selection for Surgery in RCC with Thrombus. E. Jason Abel, M.D.

Patient Selection for Surgery in RCC with Thrombus. E. Jason Abel, M.D. Patient Selection for Surgery in RCC with Thrombus E. Jason Abel, M.D. RCC with venous invasion Venous invasion occurs in ~10% of RCC Surgery more complex Increased risk for morbidity Thrombus may be confined

More information

Phillips Brayford Orthopaedics 48 Tunnel Rd, Suite 203 Pottsville PA Phone: Fax: PATIENT INFORMATION

Phillips Brayford Orthopaedics 48 Tunnel Rd, Suite 203 Pottsville PA Phone: Fax: PATIENT INFORMATION PATIENT INFORMATION Name: Date of Birth: Family Physician: Referring Physician: Height: Weight: Marital Status: Single Married Separated Widowed Divorced Employment Status: Employed Unemployed Disabled

More information

OCCUPATIONAL INJURIES OF THE ELBOW

OCCUPATIONAL INJURIES OF THE ELBOW PLEASE STAND BY WEBINAR WILL BEGIN AT 12:00 PM PST FOR AUDIO: CALL 866-740-1260 / ACCESS CODE: 764-4915# JAMES VAN DEN BOGAERDE, MD OCCUPATIONAL INJURIES OF THE ELBOW Conflict of Interest Disclosure I,

More information

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome Patient information Carpal Tunnel Syndrome i Important information for all patients having Carpal Tunnel surgery. Golden Jubilee National Hospital Agamemnon Street Clydebank, G81 4DY (: 0141 951 5000 www.nhsgoldenjubilee.co.uk

More information

Carpal Tunnel Syndrome Orthopaedic Department Patient Information Leaflet. Under review. Page 1

Carpal Tunnel Syndrome Orthopaedic Department Patient Information Leaflet. Under review. Page 1 Carpal Tunnel Syndrome Orthopaedic Department Patient Information Leaflet Page 1 Carpal Tunnel Syndrome Carpal tunnel syndrome (CTS) is a common problem which affects the hand and wrist. Symptoms are caused

More information

Mr David A McDonald Service Improvement Manager Whole System patient Flow Improvement Programme Scottish Government

Mr David A McDonald Service Improvement Manager Whole System patient Flow Improvement Programme Scottish Government Mr David A McDonald Service Improvement Manager Whole System patient Flow Improvement Programme Scottish Government Introduction Brief update Two main topics Use of Gabapentin Local Infiltration Analgesia

More information

CUBITAL TUNNEL SYNDROME GUIDANCE

CUBITAL TUNNEL SYNDROME GUIDANCE CUBITAL TUNNEL SYNDROME GUIDANCE Author Louise Ross (Louise.Ross@ggc.scot.nhs.uk) Organisation NHS Greater Glasgow and Clyde Created 15/04/2016 15:32:54 Modified 26/10/2016 16:17:15 Modified By Louise

More information

Non-Arthroplasty Hip Surgery. Javad Parvizi MD FRCS Professor of Orthopaedic Surgery

Non-Arthroplasty Hip Surgery. Javad Parvizi MD FRCS Professor of Orthopaedic Surgery Non-Arthroplasty Hip Surgery Javad Parvizi MD FRCS Professor of Orthopaedic Surgery Subcapital reduction osteotomy Relative lengthening of femoral neck (Perthes) AVN surgery Femoral osteotomy Trap door

More information

Evaluation of Tingling and Numbness in the Upper Extremities

Evaluation of Tingling and Numbness in the Upper Extremities Evaluation of Tingling and Numbness in the Upper Extremities DR. W. ANTHONY FRISELLA M.D. ADVANCED BONE & JOINT, ST CHARLES MO MONA 2018 Overview Polyneuropathy Compressive nerve lesions Carpal tunnel

More information

Endoscopic Carpal Tunnel Release A Prospective Study of Functional Outcome

Endoscopic Carpal Tunnel Release A Prospective Study of Functional Outcome Endoscopic Carpal Tunnel Release A Prospective Study of Functional Outcome T Ravindran, MS Ortho, T Sara, FRCS, YC Loh, FRCS Department of Orthopaedics, University Malaya Medical Centre, Kuala Lumpur,

More information

Cervical Disc Arthroplasty A Technology Overview

Cervical Disc Arthroplasty A Technology Overview Cervical Disc Arthroplasty A Technology Overview ADOPTED BY THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS BOARD OF DIRECTORS March 8, 2010 This Technology Overview was prepared using systematic review methodology,

More information

carpal tunnel get back to life Patient information about Endoscopic Surgery for the treatment of Carpal Tunnel Syndrome

carpal tunnel get back to life Patient information about Endoscopic Surgery for the treatment of Carpal Tunnel Syndrome carpal tunnel get back to life Patient information about Endoscopic Surgery for the treatment of Carpal Tunnel Syndrome what is carpal tunnel syndrome? Carpal Tunnel Syndrome (CTS) is a medical condition

More information

H.P. Teng, Y.J. Chou, L.C. Lin, and C.Y. Wong Under general or spinal anesthesia, the knee was flexed gently. In the cases of limited ROM, gentle and

H.P. Teng, Y.J. Chou, L.C. Lin, and C.Y. Wong Under general or spinal anesthesia, the knee was flexed gently. In the cases of limited ROM, gentle and THE BENEFIT OF ARTHROSCOPY FOR SYMPTOMATIC TOTAL KNEE ARTHROPLASTY Hsiu-Peng Teng, Yi-Jiun Chou, Li-Chun Lin, and Chi-Yin Wong Department of Orthopedic Surgery, Kaohsiung Veterans General Hospital, Kaohsiung,

More information

Ulnar nerve stability-based surgery for cubital tunnel syndrome via a small incision: a comparison with classic anterior nerve transposition

Ulnar nerve stability-based surgery for cubital tunnel syndrome via a small incision: a comparison with classic anterior nerve transposition Kang et al. Journal of Orthopaedic Surgery and Research (2015) 10:121 DOI 10.1186/s13018-015-0267-8 RESEARCH ARTICLE Open Access Ulnar nerve stability-based surgery for cubital tunnel syndrome via a small

More information

DIAGNOSIS AND TREATMENT OF PERIPHERAL NERVE ENTRAPMENTS AND NEUROPATHY

DIAGNOSIS AND TREATMENT OF PERIPHERAL NERVE ENTRAPMENTS AND NEUROPATHY DIAGNOSIS AND TREATMENT OF PERIPHERAL NERVE ENTRAPMENTS AND NEUROPATHY Foreword Vincent J. Mandracchia xi Preface Babak Baravarian xv From There to Here: A Personal Viewpoint after Three Decades of Neuropathy

More information

ERGONOMICS. Risk Management

ERGONOMICS. Risk Management ERGONOMICS Risk Management ERGONOMICS-What is it? Derived from two Greek words: Nomoi meaning natural laws Ergon meaning work Hence, ergonomists study human capabilities in relationship to work demands

More information

Pinni Meedha Mojutho Ammanu Dengina Koduku Part 1 Kama Kathalu

Pinni Meedha Mojutho Ammanu Dengina Koduku Part 1 Kama Kathalu Search for: Search Search Left hand numbness icd 10 code Pinni Meedha Mojutho Ammanu Dengina Koduku Part 1 Kama Kathalu This list presents a sub-set of the Read Code system based on public domain information.

More information

TENNESSEE STROKE REGISTRY QUARTERLY REPORT

TENNESSEE STROKE REGISTRY QUARTERLY REPORT TENNESSEE STROKE REGISTRY QUARTERLY REPORT Volume 1, Issue 2 July 2018 This report is published quarterly using data from the Tennessee Stroke Registry. Inside this report Data on diagnosis, gender distributions,

More information

WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL

WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL 2001 ONWSIAT 2849 WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 1966 01 [1] This appeal was heard in Sudbury on July 24, 2001, by Tribunal Vice-Chair L.J. Henderson. THE APPEAL PROCEEDINGS

More information

Patient Name: First MI Last Preferred Name. DOB: Sex: MALE FEMALE SSN: Address: Address: Relationship: Address:

Patient Name: First MI Last Preferred Name. DOB: Sex: MALE FEMALE SSN: Address:  Address: Relationship: Address: PATIENT DEMOGRAPHICS: Patient Name: First MI Last Preferred Name DOB: Sex: MALE FEMALE SSN: Address: City: State: Zip Code: Home Phone: ( ) Marital Status: Married Single Divorced Widowed Cell Phone: (

More information

James J. Mooney * and Ashley McDonell ** Introduction

James J. Mooney * and Ashley McDonell ** Introduction Opioid Administration as Predictor of Pediatric Epidural Failure James J. Mooney * and Ashley McDonell ** Background: Increasing use of regional analgesia in pediatric populations requires a better understanding

More information

Seeing the Light at the End of the Carpal Tunnel

Seeing the Light at the End of the Carpal Tunnel Seeing the Light at the End of the Carpal Tunnel Prevention & Treatment Strategies Carla Cleary, PT, DPT, CHT St. Dominic Outpatient Rehabilitation & Hand Management Center Is There Light at the End of

More information

When is Enough, Enough. The Second Opinion: When is it time to ask for help? Introduction. Disclaimer 10/3/2017

When is Enough, Enough. The Second Opinion: When is it time to ask for help? Introduction. Disclaimer 10/3/2017 When is Enough, Enough Over Treatment of Upper Extremity Disorders The Second Opinion: When is it time to ask for help? Roger A. Daley M.D., Ph.D. Professor and Director Division Hand Upper Extremity and

More information

Morton's Neurectomy Outcomes: Comparison of Plantar versus Dorsal Approaches

Morton's Neurectomy Outcomes: Comparison of Plantar versus Dorsal Approaches Morton's Neurectomy Outcomes: Comparison of Plantar versus Dorsal Approaches Alexander Habashy, 1 MD, Gonzalo Sumarriva, 2 MBBS Robert Treu@ng, 1 MD March 18-19, 2016 1 Department of Orthopedics, Ochsner

More information

A cluster RCT of enhanced pharmacy services (EPS) to improve outcomes for patients on methadone maintenance therapy (MMT)

A cluster RCT of enhanced pharmacy services (EPS) to improve outcomes for patients on methadone maintenance therapy (MMT) A cluster RCT of enhanced pharmacy services (EPS) to improve outcomes for patients on methadone maintenance therapy (MMT) M Jaffray 1, C Matheson 1, CM Bond 1, AJ Lee 1, D McLernon, 1 A Johnstone 2, L

More information

Stand-Alone Technology. Reginald Davis, M.D., FAANS, FACS Director of Clinical Research

Stand-Alone Technology. Reginald Davis, M.D., FAANS, FACS Director of Clinical Research Stand-Alone Technology Reginald Davis, M.D., FAANS, FACS Director of Clinical Research Disclosures Stand-Alone Devices Optio-C Stalif C Coalition Prevail ROI-C Technology Descriptions Optio-C A no profile,

More information

IAS 2013 Towards an HIV Cure Symposium

IAS 2013 Towards an HIV Cure Symposium In chronically HIV-1-infected patients long-term antiretroviral therapy initiated above 500 CD4/mm 3 achieves better HIV-1 reservoirs' depletion and T-cell count restoration IAS 2013 Towards an HIV Cure

More information

(a) Perform a cost-benefit analysis of diabetes screening for this group. Does it favor screening?

(a) Perform a cost-benefit analysis of diabetes screening for this group. Does it favor screening? Cameron ECON 132 (Health Economics): SECOND MIDTERM EXAM (A) Winter 18 Answer all questions in the space provided on the exam. Total of 36 points (and worth 22.5% of final grade). Read each question carefully,

More information

Cover Page. The handle holds various files of this Leiden University dissertation

Cover Page. The handle   holds various files of this Leiden University dissertation Cover Page The handle http://hdl.handle.net/1887/28958 holds various files of this Leiden University dissertation Author: Keurentjes, Johan Christiaan Title: Predictors of clinical outcome in total hip

More information

Mark VanDer Kaag 1, Ajmal Ikram 2. Hand Unit, Tygerberg Hospital University of Stellenbosch

Mark VanDer Kaag 1, Ajmal Ikram 2. Hand Unit, Tygerberg Hospital University of Stellenbosch A Prospective, Randomized Controlled Study To Determine The Radiological And Functional Outcomes Of IMN Fixation Of Distal Radius Fractures Using A Novel Device The Sonoma Wrx Distal Radius Nail Compared

More information

TENNESSEE STROKE REGISTRY QUARTERLY REPORT

TENNESSEE STROKE REGISTRY QUARTERLY REPORT TENNESSEE STROKE REGISTRY QUARTERLY REPORT Volume 1, Issue 3 September 2018 This report is published quarterly using data from the Tennessee Stroke Registry. Inside this report Data on diagnosis, gender

More information

A Patient s Guide to Elbow Dislocation

A Patient s Guide to Elbow Dislocation A Patient s Guide to Elbow Dislocation 20295 NE 29th Place, Ste 300 Aventura, FL 33180 Phone: (786) 629-0910 Fax: (786) 629-0920 admin@instituteofsports.com DISCLAIMER: The information in this booklet

More information

Steven Feinberg MD Andrew Sew Hoy MD

Steven Feinberg MD Andrew Sew Hoy MD Steven Feinberg MD Andrew Sew Hoy MD COA Conference April 17 th 2010 September 3 rd 2009 PD Rating rebuttable may use any method within the Guides of the Evaluation of Permanent Impairment 5 th Edition

More information

FAQ & Troubleshooting FLEXTEND

FAQ & Troubleshooting FLEXTEND FAQ & Troubleshooting FLEXTEND What is FLEXTEND? FLEXTEND is an exercise device that is used about 5-10 minutes daily to actively stretch and strengthen muscles in the hand and wrist, alleviating pressure

More information

Physical Therapist. Lauren Sisco

Physical Therapist. Lauren Sisco Physical Therapist Lauren Sisco What is a Physical Therapist? A physical therapist (PT) is a professional who examines an injured or ill patient and develops a care plan that encourages movement, reduces

More information

Alma Mater Studiorum Università di Bologna

Alma Mater Studiorum Università di Bologna Alma Mater Studiorum Università di Bologna S.Orsola-Malpighi, Bologna, Italia Chirurgia Vascolare The volume of cerebral ischaemic lesion predicts the outcome after symptomatic carotid revascularisation

More information

The future of healthcare is data.

The future of healthcare is data. The future of healthcare is data. Experience Real Engagement. Real Data. In Real Time. TracPatch will provide the healthcare market with evidence-based care, predictive analytics, and remote monitoring.

More information

Botulinum Toxin A: Treatment of Hyperhidrosis

Botulinum Toxin A: Treatment of Hyperhidrosis Botulinum Toxin A: Treatment of Hyperhidrosis Dee Anna Glaser, M.D. FAAD Professor Interim Chairman Director of Cosmetic & Laser Surgery Department of Dermatology Professor ENT & Internal Medicine Saint

More information

A Structural Service Plan: Towards Better and Safer Spine Surgeries. Department of Orthopaedics & Traumatology Tuen Mun Hospital

A Structural Service Plan: Towards Better and Safer Spine Surgeries. Department of Orthopaedics & Traumatology Tuen Mun Hospital A Structural Service Plan: Towards Better and Safer Spine Surgeries Department of Orthopaedics & Traumatology Tuen Mun Hospital Cheung KK Wong CY Chan Andrew Tse Alfred Chow YY Department of Orthopaedics

More information

Name Date. Date of Birth Social Security #: Street Address. City State Zip. Home Phone Cell Phone Address. Employer Business Phone

Name Date. Date of Birth Social Security #: Street Address. City State Zip. Home Phone Cell Phone  Address. Employer Business Phone Version 7/2/2015 Barcode Label Interviewer: Office: **PLEASE USE BLACK INK** Patient Information Private Health Patient Name Date Date of Birth Social Security #: Street Address City State Zip Home Phone

More information

Thoracic Outlet Syndrome

Thoracic Outlet Syndrome Thoracic Outlet Syndrome Part 1: The Scalene Triangle TOS: Vascular Symptom Presentation Venous persistent/intermittent edema heaviness and fatigue deep pain in neck/shoulder increased pain at night warm

More information

D E L L O N I N S T I T U T E S F O R P E R I P H E R A L N E R V E S U R G E R Y

D E L L O N I N S T I T U T E S F O R P E R I P H E R A L N E R V E S U R G E R Y Thoracic Outlet (TOS), Winged Scapula, Brachial Plexus Compression 12 D E L L O N I N S T I T U T E S F O R P E R I P H E R A L N E R V E S U R G E R Y 1122 KENILWORTH DRIVE, SUITE 18, TOWSON, MARYLAND

More information

Functional Status Questionnaire & Pain Catastrophizing Scale. A Presentation by: Jacob leroux, NAM NGUYEN & DEREK TITUS

Functional Status Questionnaire & Pain Catastrophizing Scale. A Presentation by: Jacob leroux, NAM NGUYEN & DEREK TITUS Functional Status Questionnaire & Pain Catastrophizing Scale A Presentation by: Jacob leroux, NAM NGUYEN & DEREK TITUS Objectives 1. Understand and employ the functional status questionnaire; 2. Define

More information

Chiropractic Health Dr. Art Vanderhoef

Chiropractic Health Dr. Art Vanderhoef Patient Information Form Chiropractic Health Dr. Art Vanderhoef File # Name Address City State Zip Home Phone ( ) Work Phone ( ) Cell Phone ( ) Email Address How do you prefer to be contacted? Mail Home

More information

Students were asked to report how far (in miles) they each live from school. The following distances were recorded. 1 Zane Jackson 0.

Students were asked to report how far (in miles) they each live from school. The following distances were recorded. 1 Zane Jackson 0. Identifying Outliers Task Students were asked to report how far (in miles) they each live from school. The following distances were recorded. Student Distance 1 Zane 0.4 2 Jackson 0.5 3 Benjamin 1.0 4

More information

1 Workers Compensation Issues in Upper Extremity Orthopaedics Bernard F. Hearon, M.D. Clinical Assistant Professor, Department of Surgery University

1 Workers Compensation Issues in Upper Extremity Orthopaedics Bernard F. Hearon, M.D. Clinical Assistant Professor, Department of Surgery University 1 Workers Compensation Issues in Upper Extremity Orthopaedics Bernard F. Hearon, M.D. Clinical Assistant Professor, Department of Surgery University of Kansas School of Medicine - Wichita March 2, 2012

More information

Functional Capacity Evaluation

Functional Capacity Evaluation Functional Capacity Evaluation To: Mary G Jones ABC Insurance 1000 Main Street, Suite A Anytown, US 12345 Phone: Fax: Re: Mark Smith Case Number: Sample Social Security Number: 123-45-6789 Evaluation Date:

More information

SUMMARY DECISION NO. 1689/98. Carpal tunnel syndrome.

SUMMARY DECISION NO. 1689/98. Carpal tunnel syndrome. SUMMARY DECISION NO. 1689/98 Carpal tunnel syndrome. The worker appealed a decision of the Appeals Officer denying entitlement for carpal tunnel syndrome. The condition was a disablement from the nature

More information

No Disclosure. Aortic Dissection in Japan. This. The Challenge of Acute and Chronic Type B Aortic Dissections with Endovascular Aortic Repair

No Disclosure. Aortic Dissection in Japan. This. The Challenge of Acute and Chronic Type B Aortic Dissections with Endovascular Aortic Repair No Disclosure The Challenge of Acute and Chronic Type B Aortic Dissections with Endovascular Aortic Repair Toru Kuratani Department of Cardiovascular Surgery Osaka University Graduate School of Medicine,

More information

A CLINICAL SCREENING TOOL FOR PHYSIOTHERAPY AFTER

A CLINICAL SCREENING TOOL FOR PHYSIOTHERAPY AFTER A CLINICAL SCREENING TOOL FOR PHYSIOTHERAPY AFTER CARDIAC SURGERY Chelliah Paramasivan-Deputy Team Leader Physiotherapist. AIMS To develop and implement a screening tool In uncomplicated cardiac surgery

More information

Supplemental Material. Experiment 1: Face Matching with Unlimited Exposure Time

Supplemental Material. Experiment 1: Face Matching with Unlimited Exposure Time Supplemental Material Experiment : Face Matching with Unlimited Exposure Time Participants. In all experiments, participants were volunteer undergraduate students enrolled at The University of Texas at

More information

H CAHPS Results for End of Sept 2010 Dec 2010

H CAHPS Results for End of Sept 2010 Dec 2010 H CAHPS Results for End of Sept 2010 Dec 2010 34 patients to be contacted 23 successfully contacted 11 could not be reached (never answered phone) Note: Intracranial pts and non elective admissions excluded

More information

ANKLE OSTEOCHONDRAL ALLOGRAFTS

ANKLE OSTEOCHONDRAL ALLOGRAFTS ANKLE OSTEOCHONDRAL ALLOGRAFTS UNIVERSITY OF CALIFORNIA, SAN DIEGO CHOLL KIM, M.D., Ph.D. AMIR JAMALI, M.D. F. RICHARD CONVERY, M.D. WILLIAM BUGBEE, M.D. ANKLE OSTEOCHONDRAL ALLOGRAFTS BACKGROUND - ORGAN

More information

A Patient s Guide to. Ulnar Collateral Ligament Reconstruction (Tommy John Surgery)

A Patient s Guide to. Ulnar Collateral Ligament Reconstruction (Tommy John Surgery) A Patient s Guide to Ulnar Collateral Ligament Reconstruction (Tommy John Surgery) 228 West Main St., Suite D Missoula, MT 59802-4345 Phone: 406-721-3072 Fax: 406-721-2619 info@eorthopod.com DISCLAIMER:

More information

ABSTRACT TITLE: Near-OR Perioperative Interventions to Decrease Hospital Length

ABSTRACT TITLE: Near-OR Perioperative Interventions to Decrease Hospital Length ABSTRACT NUMBER: 020-0094 ABSTRACT TITLE: Near-OR Perioperative Interventions to Decrease Hospital Length of Stay AUTHORS: Mark J. Lenart, MD Vanderbilt University 1301 Medical Center Drive Nashville,

More information

Evaluating the Effectiveness of Current Orthopaedic Pain Management Strategies

Evaluating the Effectiveness of Current Orthopaedic Pain Management Strategies Evaluating the Effectiveness of Current Orthopaedic Pain Management Strategies TOPICS: Impact of Health Care Changes Current Strategies in Surgical Pain Management Implementing and Evaluating Pain Management

More information

Gi-Soo Lee, Chan Kang*, You Gun Won, Byung-Hak Oh, June-Bum Jun

Gi-Soo Lee, Chan Kang*, You Gun Won, Byung-Hak Oh, June-Bum Jun Comparison of Postoperative Pain Control Methods After Bony Surgery In the Foot And Ankle Gi-Soo Lee, Chan Kang*, You Gun Won, Byung-Hak Oh, June-Bum Jun Department of Orthopedic Surgery, College of Medicine,

More information

Ambulatory Knee Arthroplasty

Ambulatory Knee Arthroplasty Ambulatory Knee Arthroplasty Harlan B. Levine, MD Hartzband Center for Hip & Knee Replacement Hackensack University Medical Center Hackensack, New Jersey Disclosure Zimmer Consultant Biomet Consultant

More information