Outcome of carpal tunnel release surgery in patients with and without Linburg–Comstock anomaly

Abstract

Anatomical variations may entail increased volume within the carpal tunnel and consequently the development of carpal tunnel syndrome (CTS) symptoms. The clinical importance of anomalous connection between the flexor pollicis longus (FPL) and flexor digitorum profundus (FDP) tendons was described by Linburg and Comstock. The objective of the present study was to compare postoperative outcomes of carpal tunnel release surgery in patients with and without Linburg–Comstock anomaly (LCA). Hands of CTS patients with and without LCA were evaluated for finger sensitivity, grip, tip, key and tripod pinch strength, pain intensity and Boston Carpal Tunnel Questionnaire score. Patients were evaluated preoperatively and 1, 3 and 6 months after surgery. Forty-six hands in 36 CTS patients with LCA and 50 hands in 38 patients without LCA were included. On all study parameters, no significant difference was found between CTS patients with versus without LCA. As outcomes are similar in both cases, LCA resection is not useful in patients with LCA and CTS. Preoperative diagnosis is unnecessary and screening for LCA is non-contributive for CTS evaluation.