Abstract
Rationale Carpal tunnel syndrome (CTS) is the most frequently encountered compressive neuropathy of the upper limb. The treatment of CTS ranges from conservative management to carpal tunnel release. Many patients with misconception about the potential morbidity and with the hope of successful conservative treatment delay the surgical release of carpal tunnel. This delay results in reduced recovery of sensory and motor median nerve function. Objective The aim of this study was to evaluate the influence of preoperative duration and severity of symptom on the outcome of carpal tunnel surgery. Method It included 45 cases of CTS, all treated with limited access open carpal tunnel release. The duration of symptoms (i.e., pain, numbness, tingling, waking up at night because of pain/numbness, difficulty in grasping small objects, and their preoperative severity) was noted using Boston CTS questionnaire. To investigate the outcome, patients were divided into three groups based on their duration of symptoms. Result Group1: The severity of symptoms was reduced to normal in a short period of time in patients who presented with duration of symptoms less than 6 months. Group 2: Patients in whom symptoms lasted for 6 to 12 months had reduced or delayed recovery of hand function as compared with first group. Group 3: Patients who had symptoms for more than 12 months had incomplete recovery of grip strength. Return to normal function took the longest time (median: 16 weeks) in this group. Conclusion This study suggests that patients who present late have delayed/incomplete relief of symptoms after carpal tunnel release.
Highlights
Carpal tunnel syndrome (CTS) is the most frequently encountered compressive neuropathy of the upper limb
This study suggests that patients who present late have delayed/incomplete relief of symptoms after carpal tunnel release
Of the 40 patients who underwent surgery, 5 patients (11%) had bilateral CTS and all were analyzed for each hand separately
Summary
Carpal tunnel syndrome (CTS) is the most frequently encountered compressive neuropathy of the upper limb. The American Academy of Orthopedic Surgeons defines CTS as “A symptomatic compression neuropathy of the median nerve at the level of wrist.”. The symptoms include numbness of medial three digits of the hand, reduced manual strength, tingling sensation, nocturnal numbness/pain, and difficulty in gripping small objects.[1]. CTS accounts for 90% of all nerve entrapment syndromes. Its prevalence in general population is reported as 3.8%, with an incidence of 276:100,000 per year.[1] Its release is the most commonly performed elective hand operation with 0.82 to
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