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. 2007 Mar;2(1):27-33.
doi: 10.1007/s11552-006-9019-x.

A prospective, longitudinal outcome study of patients with carpal tunnel surgery and the relationship of body mass index

Venkata Krishna Rao Bodavula  1 , Frank D Burke, Norman H Dubin, Mary J Bradley, E F Shaw Wilgis
Affiliations

A prospective, longitudinal outcome study of patients with carpal tunnel surgery and the relationship of body mass index

Venkata Krishna Rao Bodavula et al. Hand (N Y). 2007 Mar.

Abstract

This study investigated whether body mass index (BMI) was associated with effectiveness of carpal tunnel release as measured by physical and self-assessment tests. This prospective, longitudinal study was conducted from March 2001 to March 2003 using 598 cases (hands) diagnosed with carpal tunnel syndrome and scheduled for surgery at The Curtis National Hand Center, Baltimore, Maryland, and at the Pulvertaft Hand Centre, Derby, England. Body mass index was calculated, and demographic, clinical, and functional data were collected preoperatively and at 6-month follow-up. Grip, pinch, and Semmes-Weinstein scores were measured preoperatively and at 6-month follow-up. Levine-Katz self-assessment scores for symptom severity and functional status were measured preoperatively and at 6-month follow-up. Grip and pinch increased, whereas Semmes-Weinstein, symptom severity, and functional scores decreased by 6-month follow-up. Cases with BMI >35 had lower grip strength and higher symptom severity in males and higher functional status in both sexes pre- and postoperatively compared to normal-weight BMI cases. BMI had no relationship to patient satisfaction. Although morbidly obese cases did worse on some physical and self-assessment tests compared to normal BMI cases preoperatively, all improved to the same extent postoperatively regardless of BMI.

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Figures

Figure 1
Figure 1
Prevalence of Tinel’s sign preoperatively and at 6-month follow-up for males (a) and females (b) in each BMI group. –––––– <25 BMI, – – – – – – 25–30 BMI, ——– >30–35 BMI, and –– – –– – –– >35 BMI. p values are from chi-square analysis for BMI effects preoperatively and at 6-month follow-up and for time (preoperative vs. 6 months) as indicated.
Figure 2
Figure 2
Prevalence of Phalen’s sign preoperatively and at 6-month follow-up for males (a) and females (b) in each BMI group. –––––– <25 BMI, – – – – – – 25–30 BMI, ——– >30–35 BMI, and –– – –– – –– >35 BMI. p values are from chi-square analysis for BMI effects preoperatively and at 6-month follow-up and for time (preoperative vs. 6 months) as indicated.
Figure 3
Figure 3
Preoperative and 6-month follow-up grip strength for males (a) and females (b) in each BMI group. –––––– <25 BMI, – – – – – – 25–30 BMI, ——– >30–35 BMI, and –– – –– – –– >35 BMI. p values are from two-factor ANOVA with BMI categories and time (preoperative vs. 6 months) as main effects and BMI × time interactions (Int).
Figure 4
Figure 4
Preoperative and 6-month follow-up pinch strength for males (a) and females (b) in each BMI group. –––––– <25 BMI, – – – – – – 25–30 BMI, ——– >30–35 BMI, and –– – –– – –– >35 BMI. p values are from two-factor ANOVA with BMI categories and time (preoperative vs. 6 months) as main effects and BMI × time interactions (Int).
Figure 5
Figure 5
Preoperative and 6-month follow-up Semmes–Weinstein scores for males (a) and females (b) in each BMI group. –––––– <25 BMI, – – – – – – 25–30 BMI, ——– >30–35 BMI, and –– – –– – –– >35 BMI. p values are from two-factor ANOVA with BMI categories and time (preoperative vs. 6 months) as main effects and BMI × time interactions (Int).
Figure 6
Figure 6
Satisfaction for males (a) and females (b) in each BMI group.
Figure 7
Figure 7
Preoperative and 6-month follow-up symptom severity scores for males (a) and females (b) in each BMI group. –––––– <25 BMI, – – – – – – 25–30 BMI, ——– >30–35 BMI, and –– – –– – –– >35 BMI. p values are from two-factor ANOVA with BMI categories and time (preoperative vs. 6 months) as main effects and BMI × time interactions (Int).
Figure 8
Figure 8
Preoperative and 6-month follow-up functional status scores for males (a) and females (b) in each BMI group. –––––– <25 BMI, – – – – – – 25–30 BMI, ——– >30–35 BMI, and –– – –– – –– >35 BMI. p values are from two-factor ANOVA with BMI categories and time (preoperative vs. 6 months) as main effects and BMI × time interactions (Int).
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