Long-term outcome of carpal tunnel release surgery in patients with severe carpal tunnel syndrome

Bone Joint J. 2017 Oct;99-B(10):1348-1353. doi: 10.1302/0301-620X.99B10.BJJ-2016-0587.R2.

Abstract

Aims: Few studies have examined the long-term outcome of carpal tunnel release (CTR). The aim of this study was to evaluate the patient-reported long-term outcome of CTR for electrophysiologically severe carpal tunnel syndrome (CTS).

Patients and methods: We reviewed the long-term outcome of 40 patients with bilateral severe CTS who underwent 80 CTRs (46 open, 34 endoscopic) between 2002 and 2012. The outcomes studied were patient-reported outcomes of numbness resolution, the Boston Carpal Tunnel Questionnaire (BCTQ) score, and patient satisfaction.

Results: The mean follow-up was 9.3 years. Complete resolution of numbness was reported by 93.8% of patients, persistent numbness by 3.8%, and recurrent numbness by 2.5%. The mean BCTQ symptom score was 1.1 (sd 0.3; 1.0 to 2.55) and the mean Boston function score was 1.15 (sd 0.46; 1.0 to 3.5). 72.5% of patients were asymptomatic and had no functional impairment. Men had poorer outcomes than women and patients < 55 years had poorer outcomes than patients ≥ 55 years. All patients who had undergone endoscopic CTR reported complete resolution of numbness compared with 89.1% of those who had undergone open release (p = 0.047). There was no significant difference in outcome between dominant and non-dominant hands. Patient satisfaction rates were good. There were no adverse events.

Conclusion: CTR has a favourable outcome and good rates of satisfaction, even in patients with bilateral severe CTS at a mean of nine years after surgery. Endoscopic CTR has a higher rate of numbness resolution than open surgery. There were no significant differences in outcome between the dominant and non-dominant hand. Cite this article: Bone Joint J 2017;99-B:1348-53.

Keywords: Carpal tunnel release; Long-term outcomes; Patient-reported outcomes; Severe carpal tunnel syndrome.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carpal Tunnel Syndrome / diagnosis
  • Carpal Tunnel Syndrome / physiopathology
  • Carpal Tunnel Syndrome / surgery*
  • Endoscopy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Orthopedic Procedures / methods*
  • Patient Satisfaction*
  • Recovery of Function*
  • Retrospective Studies
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome