Our Summary

This research looked at how the involvement of trainee surgeons and surgical assistants might impact the outcomes of operations for cubital tunnel syndrome - a condition where the ulnar nerve in the arm is compressed, causing numbness and tingling in the fingers.

The study looked back at the cases of 274 patients who had this surgery between June 2015 and March 2020. They were split into four groups based on who the main surgical assistant was: a physician associate, an orthopaedic or plastic surgery resident, a hand surgery fellow, or both residents and fellows.

The results showed that the type of surgical assistant didn’t impact the length of the surgery, the complication rate, or the need for further operations. The only significant difference was that physician associates were more likely to use a specific surgical technique called ‘subcutaneous transposition’.

The study concluded that having trainee surgeons involved in these operations is safe and doesn’t affect the outcomes of the surgery. This is important information for training future surgeons and ensuring patient safety.

FAQs

  1. Does the involvement of trainee surgeons impact the outcomes of operations for cubital tunnel syndrome?
  2. Does the type of surgical assistant affect the length of the surgery, the complication rate, or the need for further operations?
  3. What was the only significant difference found in the study regarding the role of the surgical assistant in operations for cubital tunnel syndrome?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hand surgery is to ask about the experience level of the surgical team. It is reassuring to know that having trainee surgeons involved in the operation is safe and does not affect the outcomes. Patients can feel confident knowing that their surgery is in capable hands, regardless of who the main surgical assistant may be.

Suitable For

Patients who are typically recommended hand surgery include those with conditions such as carpal tunnel syndrome, trigger finger, arthritis of the hand or wrist, tendon injuries, nerve injuries, fractures, or congenital abnormalities. Additionally, patients with conditions like cubital tunnel syndrome, mentioned in the study above, may also be recommended for hand surgery.

Timeline

Before surgery:

  1. Patient experiences symptoms of cubital tunnel syndrome, such as numbness and tingling in the fingers.
  2. Patient consults with a hand surgeon to discuss their symptoms and treatment options.
  3. Hand surgeon recommends surgery to relieve the compression of the ulnar nerve.
  4. Patient undergoes pre-operative testing and evaluation to ensure they are a suitable candidate for surgery.

During surgery:

  1. Patient is placed under anesthesia.
  2. Hand surgeon and surgical team perform the surgery to release the compression of the ulnar nerve.
  3. Depending on the type of surgical assistant, different techniques may be used during the operation.

After surgery:

  1. Patient is monitored in the recovery room before being discharged home.
  2. Patient may experience pain and discomfort in the hand and arm post-surgery.
  3. Patient follows a rehabilitation plan, which may include physical therapy to regain strength and range of motion in the hand.
  4. Patient attends follow-up appointments with the hand surgeon to monitor their progress and ensure proper healing.
  5. Patient gradually resumes daily activities and work as advised by the surgeon.

Overall, the involvement of trainee surgeons and surgical assistants in hand surgery for cubital tunnel syndrome is found to be safe and does not impact the outcomes of the surgery. This study provides valuable information for both patients and healthcare professionals involved in the treatment of this condition.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hand surgery for cubital tunnel syndrome include:

  1. Can you explain the specific surgical technique you plan to use for my procedure?
  2. Will there be any trainee surgeons or surgical assistants involved in my surgery?
  3. What experience do the trainee surgeons or surgical assistants have in performing this type of surgery?
  4. How will the involvement of trainee surgeons or surgical assistants affect the overall outcome of my surgery?
  5. Are there any potential risks or complications associated with having trainee surgeons or surgical assistants involved in the procedure?
  6. Will the type of surgical assistant involved impact the length of the surgery or the need for further operations?
  7. How will you ensure that the surgery is performed safely and effectively with the involvement of trainee surgeons or surgical assistants?
  8. Are there any alternative treatment options or surgical techniques that I should consider?
  9. What is the expected recovery time and outcome for this type of surgery for cubital tunnel syndrome?
  10. Are there any specific post-operative care instructions or rehabilitation exercises that I should follow after the surgery?

Reference

Authors: Liu C, Grisdela P Jr, Liu D, Model Z, Steele A, Blazar P, Earp BE, Zhang D. Journal: J Hand Surg Asian Pac Vol. 2023 Feb;28(1):84-90. doi: 10.1142/S2424835523500133. Epub 2023 Feb 20. PMID: 36803476