Selection of therapeutic methods for carpal tunnel syndrome

Abstract

Objective To evaluate 3 therapeutic methods for carpal tunnel syndrome (CTS).Methods From May 2005 to September 2009, 162 CTS patients were treated in our hospital. Of them, 96 were mild, 54 were severe, and 12 had complete damage to the median nerve. Conservative therapy, simple carpal tunnel release (CTR) and complete carpal tunnel & palmar aponeurosis release (CTPAR) were selected for different types of CTS. Clinical presentations, electroneurophysiological results and Chen W-S evaluation scores of the patients were compared before and after therapy. Results For slight CTS cases, all the 3 methods improved obviously the clinical presentations. The Chen WS scores were increased from 73.1 ± 6. 5before therapy to 94. 9 ± 8.7 after therapy. There was no significant difference between surgery and conservative therapy. For Severe CTS, all the 3 methods were effective. CTR increased the Chen W-S score by 24.6 ± 8.2 points while CTPAR by 33.9 ± 7.5 points. Of the 3 methods, surgery was superior to conservative therapy and CTPAR was superior to CTR. For complete damage to the median nerve, none of the 3 methods was effective. Conclusions Early diagnosis and treatment is crucial for a fine functional recovery for CTS patients. Different therapeutic methods should be applied for CTS patients according to the severity of their injury. Key words: Carpal tunnel syndrome;  Clinical protocols;  Treatment outcome