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Surgical Techniques and Return to Work Following Carpal Tunnel Release: A Systematic Review and Meta-Analysis

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Abstract

Introduction This systematic review was conducted to evaluate return to work (RTW) following minimally invasive carpal tunnel surgery versus open carpal tunnel release. This study also assesses how RTW as an outcome measure was examined in previous randomized controlled trials (RCTs). Methods The bibliographic databases Medline, AMED and CINAHL were systematically searched. We found 15 relevant RCTs. Meta-analysis was possible only for four studies. Results The result indicates that minimally invasive surgery offers earlier return to work compared to open carpal tunnel release (mean difference −7.2 days; 95% CI −10 to −4.4 days). There were remarkable inconsistencies in how return to work as an outcome measure was examined in different RCTs. Conclusions Calculating standardised mean difference in future RCTs would allow future reviews to be more inclusive of the evidence. The authors suggest more consistent approach for evaluating work-related features in future studies. We recommend that new fit note categories introduced by UK Department of Work and Pension (unfit for all work/return to modified work or work adaptations/return to normal work) would be used to identify different levels of return to work.

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Acknowledgments

The authors extend their thanks to Dr Olivia Wu and Dr Amir Sadr for their valuable comments and assistance in this study.

Conflict of Interest

None.

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Authors and Affiliations

  1. Healthy Working Lives Group, Public Health and Health Policy Section, University of Glasgow, G12 8RZ, Glasgow, Scotland, UK

    Kaveh A. Sanati & Ewan Macdonald

  2. Section of Pharmacology, Therapeutics & Toxicology, Cardiff University, Cardiff, CF14 4XN, UK

    Massoud Mansouri

  3. The Pulvertaft Hand Centre, Royal Derby Hospital, Derby, UK

    Duncan Macdonald

  4. Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Shahab Ghafghazi

  5. Faculty of Medicine, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK

    Ghasem Yadegarfar

  6. School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran

    Ghasem Yadegarfar

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  1. Kaveh A. Sanati
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  2. Massoud Mansouri
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  3. Duncan Macdonald
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  4. Shahab Ghafghazi
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Correspondence to Kaveh A. Sanati.

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Sanati, K.A., Mansouri, M., Macdonald, D. et al. Surgical Techniques and Return to Work Following Carpal Tunnel Release: A Systematic Review and Meta-Analysis. J Occup Rehabil 21, 474–481 (2011). https://doi.org/10.1007/s10926-011-9310-8

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  • DOI: https://doi.org/10.1007/s10926-011-9310-8

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