Surgery versus conservative therapy in carpal tunnel syndrome in people aged 70 years and older.
BACKGROUND
Carpal tunnel syndrome is common in the general population, with a prevalence that increases with age. Although good satisfaction has been described after carpal tunnel release, little is known about the long-term outcome of treatment in elderly individuals with carpal tunnel syndrome.


METHODS
The authors reviewed data from a population-based sample of 102 patients aged 70 years and older with carpal tunnel syndrome. They used valid and sensitive mailed follow-up outcome [Boston Carpal Tunnel, satisfaction (American Academy of Orthopaedic Surgeons), and health status (Short Form-36) questionnaires to assess symptoms, functional status, expectations of treatment, and satisfaction with the results at a minimum of 2 years after initial diagnosis.


RESULTS
Seventy patients with a mean age of 77.0 years (range, 70.2 to 88.5 years) responded to the survey, with a mean follow-up of 4.8 years. Patients who had surgery were more likely to have had more severe disease than those treated nonoperatively (Mantel-Haentzel test, p < 0.001). Satisfaction was 93 percent after surgical treatment and 54 percent after nonsurgical treatment. Patients who had surgery had significantly better relief of symptoms (t test, p < 0.01), functional status (t test, p < 0.05), satisfaction (t test, p < 0.001), and expectations with treatment (t test, p < 0.05) scores as compared with those who had nonsurgical treatment.


CONCLUSIONS
In patients over the age of 70, surgery appears to be associated with better symptom relief, functional status, satisfaction, and expectations with treatment than nonoperative therapy does. Age should not be considered a contraindication for carpal tunnel surgery, nor should nonoperative therapy be favored in this age group.
Ettema
Anke M
AM
Rochester, Minn. From the Biomechanics Laboratory, Division of Orthopedic Research; Health Sciences Research, Division of Biostatistics; and Survey Research Center, Division of Biostatistics, Mayo Clinic.
Amadio
Peter C
PC
Cha
Stephen S
SS
Harrington
Jeffrey R
JR
Harris
Ann M
AM
Offord
Kenneth P
KP
D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000601:surgery / Q000628:therapy*; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D017060:Patient Satisfaction; D020127:Recovery of Function; D016896:Treatment Outcome