Symptoms, functional status, and neuromuscular impairment following carpal tunnel release.
This study examined the resolution of symptoms, functional limitations and neuromuscular impairments following carpal tunnel release. Thirty-five patients were evaluated preoperatively and 6 weeks, 3 months, 6 months, and a mean of 27 months postoperatively. Evaluation consisted of physical examination (performed in a subset of patients) and previously validated questionnaire scales measuring symptoms, functional limitations, and satisfaction. Nocturnal pain, tingling, and numbness improved within 6 weeks after surgery. Weakness and functional status improved more gradually. Grip and pinch strength worsened initially, returned to pre-operative levels after about 3 months, and improved significantly by 24 months. The Tinel and Phalen signs remained positive in two and seven patients, respectively, after 2 years, and two-point discrimination remained abnormal in over half of patients after 2 years. These temporal patterns should be discussed with patients to foster realistic expectations of the response to surgery.
Katz
J N
JN
Robert Bingham Multipurpose Arthritis and Musculoskeletal Disease Center, Department of Rheumatology/Immunology, Brigham and Women's Hospital, Boston, MA 02115, USA.
Fossel
K K
KK
Simmons
B P
BP
Swartz
R A
RA
Fossel
A H
AH
Koris
M J
MJ
D002349:Carpal Tunnel Syndrome / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006225:Hand / Q000503:physiopathology*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010808:Physical Examination; D013997:Time Factors; D016896:Treatment Outcome