title: Symptoms, functional status, and neuromuscular impairment following carpal tunnel release.
abstract: 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.
authors.affiliation: Robert Bingham Multipurpose Arthritis and Musculoskeletal Disease Center, Department of Rheumatology/Immunology, Brigham and Women's Hospital, Boston, MA 02115, USA.
authors.forename: J N
authors.initials: JN
authors.lastname: Katz
authors.forename: K K
authors.initials: KK
authors.lastname: Fossel
authors.forename: B P
authors.initials: BP
authors.lastname: Simmons
authors.forename: R A
authors.initials: RA
authors.lastname: Swartz
authors.forename: A H
authors.initials: AH
authors.lastname: Fossel
authors.forename: M J
authors.initials: MJ
authors.lastname: Koris
mesh_terms: 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