Outcome of surgical release among diabetics with carpal tunnel syndrome

Abstract

Mondelli M, Padua L, Reale F, Signorini AM, Romano C. Outcome of surgical release among diabetics with carpal tunnel syndrome. Arch Phys Med Rehabil 2004;85:7–13. Objective To compare the results of surgical decompression of carpal tunnel syndrome (CTS) in patients with diabetes with those of patients with idiopathic CTS. Design Prospective case series. Setting Ambulatory care in Italy. Participants Twenty-four consecutive patients with diabetes type 1 or 2 and CTS (mean age, 66.7y) were matched for age and sex with 72 patients (mean age, 66.2y) with idiopathic CTS. Interventions All patients underwent surgical release of CTS by the mini-incision of palm technique. Main outcome measures Clinical and electrophysiologic evaluation and patient self-administered Boston Questionnaire (BQ) for the assessment of severity of CTS symptoms and hand functional status before and 1 and 6 months after surgery. Results After surgical release, almost all patients of both groups reported an absence of pain, disappearance or reduction of paresthesia, and improvement in hand function. One month after surgery, there was a significant improvement in clinical status, BQ scores, and distal conduction velocities of the median nerve. A further improvement was evident at 6-month follow-up. There were no differences between the 2 groups in the number of surgical complications, in clinical and electrophysiologic status, or in BQ scores before and after surgery. The improvement in distal conduction velocities of the median nerve, BQ scores, and clinical and electrophysiologic status were similar in the 2 groups after surgery. Conclusion Diabetes is not a risk factor for poor outcome of surgical decompression of CTS. Patients with diabetes have the same probability of positive surgical outcome as patients with idiopathic CTS.