Your browser doesn't support javascript.
loading
A Comparison of Early Complication Rates of Endoscopic Carpal Tunnel Release With and Without Resident Involvement.
Grandizio, Louis C; Mettler, Alexander W; Hayes, Daniel S; Garcia, Victoria C; El Koussaify, Jad; Manzar, Shahid; Klena, Joel C.
Afiliação
  • Grandizio LC; Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Geisinger Health System, Danville, PA. Electronic address: chris.grandizio@gmail.com.
  • Mettler AW; Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Geisinger Health System, Danville, PA.
  • Hayes DS; Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Geisinger Health System, Danville, PA.
  • Garcia VC; Henry Hood Research Center, Biostatistics Core, Geisinger Health System, Danville, PA.
  • El Koussaify J; Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Geisinger Health System, Danville, PA.
  • Manzar S; Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Geisinger Health System, Danville, PA.
  • Klena JC; Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Geisinger Health System, Danville, PA.
J Hand Surg Am ; 49(3): 222-229, 2024 Mar.
Article em En | MEDLINE | ID: mdl-38159093
ABSTRACT

PURPOSE:

The purpose of this study was to compare the complication rates of endoscopic carpal tunnel release (ECTR) relative to orthopedic resident trainee involvement in the procedure.

METHODS:

All patients undergoing isolated, elective ECTR by two attending surgeons within a 59-month period were analyzed. Cases were categorized as the following according to the degree of resident involvement ECTR performed by attending with either no resident or a resident as an assistant (group 1), resident performing a portion of the procedure (group 2), and resident performing the entire procedure (group 3). Early postoperative complications and/or intraoperative conversion to an open procedure were the outcomes of interest. We used a noninferiority design, hypothesizing that resident involvement would not be associated with inferior outcomes compared with cases without resident involvement. Multiple logistic regression models, adjusted for patient demographic and surgical characteristics, were fit to assess the relationship between resident involvement groups and complication/conversion outcomes.

RESULTS:

A total of 1,167 ECTR cases (895 patients) were performed and returned for postoperative follow-up for at least 2 weeks after surgery. Operative time was significantly shorter for group 1 cases versus group 2 and 3 cases. The early postoperative complication and conversion rates were 1.7% and 1.0%, respectively. Superficial infection (1.2%), deep infection (0.3%), and transient neuropraxia (0.3%) occurred infrequently and did not differ relative to resident involvement. No differences in the odds of complication and/or conversion relative to resident involvement were observed.

CONCLUSIONS:

The results of ECTR performed entirely or in part by attending-supervised resident trainees were not inferior to ECTR performed by an attending surgeon regarding the odds of experiencing complications or conversion to an open procedure. With appropriate supervision, ECTR can be performed safely by orthopedic and plastic surgery residents. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic II.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Ortopedia / Síndrome do Túnel Carpal Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Ortopedia / Síndrome do Túnel Carpal Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article