60 Comparison of Comorbidities and Need for Further Surgery of Adolescent and Adult Patients Who Undergo Carpal Tunnel Release

Abstract

Abstract Aim To compare the presenting comorbidities and need for further surgery following carpal tunnel release (CTR) surgery between the adolescent and adult populations. Method 36 consecutive patients under 25 years old who underwent CTR in a single centre were identified (43 hands). Comorbidities and further surgery in the follow up period were recorded from electronic medical records. The same data was collected from 100 randomly selected adult patients who underwent CTR in the same centre aged within one standard deviation of the mean. Outcomes included: comorbidities pre-and post-surgery, further operations and follow up in the region. Data for both cohorts were compared. Results Mean follow up was 13.3 years for adolescents and 8.6 years for adults. Adolescent patients undergoing CTR surgery were associated with higher rates of obesity (22%), mental health problems (19%) compared with the adult CTR population (11% and 7% respectively). 47% of the adolescents required at least one further nerve decompression surgery compared with 41% in adults. This was most likely to be a contralateral CTR in both patient groups. The revision rate of CTR was higher in adolescents (11%) than in adults (4%). Conclusions Mental health problems were significantly higher in younger patients undergoing CTR. Rate of further nerve decompression surgery is high in both groups. Adolescents especially should be informed of the risk of requiring future surgery following a CTR. Given the likelihood for further surgery in both cohorts, patients undergoing CTRs should be advised to reduce their modifiable risk factors for nerve entrapments.