Predicting the outcome of carpal tunnel release.
OBJECTIVE
To test the hypothesis that the result of steroid injection in the carpal tunnel provides a better predictor of the outcome of later surgery. We also explored other possible factors that might predict the outcome directly or interact with the results of steroid injection to better predict the outcome.


METHODS
We performed a historical cohort study on 57 patients who had carpal tunnel release. Care was taken to avoid problems of statistical nonindependence caused by both hands being studied and confounding from previous surgeries.


RESULTS
We found a large and significant difference in the success rate of surgery for patients who had obtained some relief from injection (87%) versus those who had not (54%). No other significant predictor was found. We discovered factors that may interact with the results of injection in predicting the outcome of surgery (eg, Katz and Stirrat hand diagram assessment of the probability of carpal tunnel syndrome) although not significant in our study.


CONCLUSIONS
Some relief from steroid injection is the best predictor for success of surgery. Further study is warranted to identify factors that interact with this predictor.
Edgell
Stephen E
SE
Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY 40292, USA.
McCabe
Steven J
SJ
Breidenbach
Warren C
WC
LaJoie
Andrew S
AS
Abell
Troy D
TD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001623:Betamethasone / Q000627:therapeutic use*; D002349:Carpal Tunnel Syndrome / Q000188:drug therapy* / Q000601:surgery*; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016896:Treatment Outcome
D005938:Glucocorticoids; D001623:Betamethasone