Time to return to work and surgeons' recommendations after carpal tunnel release.
BACKGROUND
Time to return to work after carpal tunnel release is extremely variable suggesting that only a small proportion of total sick-leave is for medical reasons.


OBJECTIVE
To determine factors predicting a delayed return to work.


METHODS
Fifty consecutive employed patients undergoing carpal tunnel surgery were tested pre-operatively, and then at 1 month post-operatively using both questionnaires and objective testing. Further follow-up by telephone was carried out every 2 weeks up until 90 days.


RESULTS
Forty-nine of the 50 workers had returned to work by 3 months. Time to return to work was extremely variable ranging from 1 to 88 days in those who returned to work. Post-operative recommendations by the surgeon also varied widely from 1 to 36 days. The surgeons' recommendations were the strongest predictors of delayed return to work [odds ratio 30.5; 95% confidence interval (CI), 3.2-288], with physical work (odds ratio 27.7; 95% CI, 1.5-507) and lack of self-rated health (odds ratio 5.0; 95% CI, 1.11-100) adding significantly to the logistic regression model, which was highly predictive (area under the receiver-operator curve of 88%). Patient symptoms and objective findings of disability did not add significantly to a logistic regression model either predicting return to work or the surgeon's recommendations.


CONCLUSIONS
Our study suggests that workers will return to work in less than 3 weeks if recommended by the surgeon. A randomized controlled trial is warranted to determine if a higher proportion of workers returning in less than 3 weeks can be obtained by standardizing surgeons' recommendations.
Ratzon
Navah
N
Department of Occupational Therapy, Tel Aviv University, PO Box 39040, Ramat Aviv, 69978 Tel Aviv, Israel. navah@post.tau.ac.il
Schejter-Margalit
Tamara
T
Froom
Paul
P
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002349:Carpal Tunnel Syndrome / Q000534:rehabilitation / Q000601:surgery*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000534:rehabilitation / Q000601:surgery*; D011182:Postoperative Care; D018582:Sick Leave / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014937:Work