Evidence-based medicine: Carpal tunnel syndrome

After studying this article, the participant should be able to: (1) Describe and apply the best current high-level evidence in carpal tunnel syndrome. (2) Design a treatment plan to offer tourniquet-free, sedation-free local anesthesia for patients who wish it or who are at high risk with sedation. (3) Describe the evidence and outcomes as they relate to splinting carpal tunnel patients after surgery.

This is the third Maintenance of Certification article on carpal tunnel syndrome. Hentz and Lalonde summarized the best literature in 2008 in the first article. The second article, by Shores and Lee, presented the best evidence regarding assessment, surgical treatment, and outcomes from the literature published between 1999 and 2009. In this article, the author has concentrated on topics not covered in depth in the first two articles and provides an update of the highest level evidence on important topics from 2009 to 2013. Although there is some Level IV and V evidence cited in this article, most is Level I, II, and III.