Bickel's 2010 Current Concepts review synthesizes AAOS evidence-based guidelines for diagnosing and treating carpal tunnel syndrome — the most common compressive neuropathy of the upper extremity — addressing which diagnostic tools, nonsurgical modalities, and surgical techniques are supported by high-level evidence versus expert consensus alone.
When evaluating a patient with suspected CTS, use the CTS-6 clinical criteria as your primary diagnostic framework — if the clinical picture is convincing and you're planning surgery, add electrodiagnostics for baseline and to exclude cervical radiculopathy, not to confirm what you already know.
When counseling patients about surgery, reassure them that neither old age nor diabetes predicts a bad outcome, but set expectations based on symptom severity; and if you're reopening a failed release, your first question should be whether the retinaculum was completely divided at the index case.
Bickel's 2010 Current Concepts review synthesizes AAOS evidence-based guidelines for diagnosing and treating carpal tunnel syndrome — the most common compressive neuropathy of the upper extremity — addressing which diagnostic tools, nonsurgical modalities, and surgical techniques are supported by high-level evidence versus expert consensus alone.
When evaluating a patient with suspected CTS, use the CTS-6 clinical criteria as your primary diagnostic framework — if the clinical picture is convincing and you're planning surgery, add electrodiagnostics for baseline and to exclude cervical radiculopathy, not to confirm what you already know.
When counseling patients about surgery, reassure them that neither old age nor diabetes predicts a bad outcome, but set expectations based on symptom severity; and if you're reopening a failed release, your first question should be whether the retinaculum was completely divided at the index case.