title: Validation of a one-stop carpal tunnel clinic including nerve conduction studies and hand therapy.
abstract: BACKGROUND
  Carpal tunnel syndrome is the most common hand disorder. We describe a pathway that includes clinical assessment, neurophysiological testing, surgery and physical therapy all at the same visit.
  
  
  METHODS
  All referrals for carpal tunnel syndrome were screened for inclusion  in a 'one-stop' surgeon-led clinic. Prospective clinical data collected included patient reported outcome measures and satisfaction scores, touch threshold, pinch and grip strength. Patients were assessed clinically, underwent nerve conduction studies and surgery as indicated, all on the same  day. Baseline and one-year follow-up data were analysed for 57 patients (62 hands).
  
  
  RESULTS
  There was significant improvement in all domains of the Boston Carpal Tunnel and Michigan hand Outcomes questionnaires, grip strength and touch threshold. There were no adverse events. The total  mean operating time was 12.8 minutes (range: 5-15 minutes) and the mean tourniquet time was 2.5 minutes (range: 1-11 minutes). Using a dual theatre model produced a short mean turnaround time of 14.8 minutes (range: 2-37 minutes). Patient satisfaction as judged using a Picker  questionnaire was very high.
  
  
  CONCLUSIONS
  A highly efficient clinical service involving both diagnostics and treatment can be delivered at a single hospital visit while maintaining optimal outcomes and high patient satisfaction.
authors: Kennedy Institute of Rheumatology, 65 Aspenlea Road, London W6 8LH, UK. cathy.ball@kennedy.ox.ac.uk
authors: C
authors: C
authors: Ball
authors: M
authors: M
authors: Pearse
authors: D
authors: D
authors: Kennedy
authors: A
authors: A
authors: Hall
authors: J
authors: J
authors: Nanchahal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000592:standards*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001623:Betamethasone / Q000627:therapeutic use; D002349:Carpal Tunnel Syndrome / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D017060:Patient Satisfaction; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D012684:Sensory Thresholds; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D001623:Betamethasone