Experience in integral management of advanced carpal tunnel syndrome in an ambulatory surgical unit

Abstract

Experience in the integral management of carpal tunnel syndrome over a period of 4 years is presented. All cases were treated at an ambulatory surgical unit. Among this series, special attention is payed to eight cases of severe advanced carpal tunnel syndrome. All cases presented in this study had at the time of evaluation at the ambulatory surgical unit, symptoms of severe pain, thenar atrophy, weakness and decreased sensation. The only treatment received by some patients in this series ( n=7), before admission at the ambulatory surgical unit, was conservative therapy, with splinting, anti-inflammatory drugs and corticosteroid infiltrations. In one case, the patient had rejected all therapeutic options and no therapy had been undertaken at the time of first clinical evaluation. Several surgical findings were found in five of the eight cases of severe carpal tunnel syndrome: Basal joint arthritis of the thumb in three patients; A ganglion in another case; A flexor tendon synovitis in another. The diagnostic procedures, the indications for surgery and the postoperative results kin such advanced carpal tunnel syndrome are analyzed and discussed.