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. 2019 Jan 22;14(1):e1-e8.
doi: 10.1055/s-0038-1668552. eCollection 2019 Jan.

Does the Duration and Severity of Symptoms Have an Impact on Relief of Symptoms after Carpal Tunnel Release?

Mehreen Masud  1 , Mamoon Rashid  1 , Saleem Akhtar Malik  1 , Muhommad Ibrahim Khan  1 , Saad-Ur-Rehman Sarwar  1
Affiliations

Does the Duration and Severity of Symptoms Have an Impact on Relief of Symptoms after Carpal Tunnel Release?

Mehreen Masud et al. J Brachial Plex Peripher Nerve Inj. .

Abstract

Rationale Carpal tunnel syndrome (CTS) is the most frequently encountered compressive neuropathy of the upper limb. The treatment of CTS ranges from conservative management to carpal tunnel release. Many patients with misconception about the potential morbidity and with the hope of successful conservative treatment delay the surgical release of carpal tunnel. This delay results in reduced recovery of sensory and motor median nerve function. Objective The aim of this study was to evaluate the influence of preoperative duration and severity of symptom on the outcome of carpal tunnel surgery. Method It included 45 cases of CTS, all treated with limited access open carpal tunnel release. The duration of symptoms (i.e., pain, numbness, tingling, waking up at night because of pain/numbness, difficulty in grasping small objects, and their preoperative severity) was noted using Boston CTS questionnaire. To investigate the outcome, patients were divided into three groups based on their duration of symptoms. Result Group1: The severity of symptoms was reduced to normal in a short period of time in patients who presented with duration of symptoms less than 6 months. Group 2: Patients in whom symptoms lasted for 6 to 12 months had reduced or delayed recovery of hand function as compared with first group. Group 3: Patients who had symptoms for more than 12 months had incomplete recovery of grip strength. Return to normal function took the longest time (median: 16 weeks) in this group. Conclusion This study suggests that patients who present late have delayed/incomplete relief of symptoms after carpal tunnel release.

Keywords: carpal tunnel release; carpal tunnel syndrome; duration of symptoms; severity of symptoms.

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Conflict of interest statement

Conflict of Interest None.

Figures

Fig. 1
Fig. 1
Preoperative marking of carpal tunnel syndrome.
Fig. 2
Fig. 2
Exposure of median nerve after release of transverse ligament.
Fig. 3
Fig. 3
Distribution of patients in each group.
Fig. 4
Fig. 4
( a ) Comparison of preoperative and postoperative severity of pain at daytime. ( b ) Comparison of preoperative and postoperative severity of pain at night. ( c ) Median duration of pain and its recovery in each group.
Fig. 5
Fig. 5
( a ) Comparison of preoperative and postoperative severity of numbness in each group. ( b ) Comparison of median duration of numbness and its recovery in three groups.
Fig. 6
Fig. 6
Comparison of preoperative and postoperative severity of tingling in each group.
Fig. 7
Fig. 7
Comparison of waking up at night before and after surgery.
Fig. 8
Fig. 8
( a ) Comparison of preoperative and postoperative weakness of grip strength. ( b ) Comparison of preoperative duration and postoperative recovery period of reduced grip strength in each group.
Fig. 9
Fig. 9
Comparison of return to work in each group.
See this image and copyright information in PMC

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