Subjective and functional outcome after revision surgery in carpal tunnel syndrome.
BACKGROUND
In spite of carpal tunnel release's prevalent good postoperative results, the number of revision surgeries needed should not be underestimated. In this study, subjective and functional results after carpal tunnel revision surgery were determined.


METHODS
Thirty-eight patients were examined approximately 2 years after their revision surgery of the carpal tunnel release. The subjective outcome of the patients was assessed using two different questionnaires (Amadio and DASH). A clinical examination was undertaken on selected patients who had persistent complaints. The clinical assessment analyzed grip strength, thumb opposition, pulp-to-pulp-pinch, key-pinch, hook-grip, Moberg-Pickup-test, two-point-discrimination, Phalen-test, and the Hoffmann-Tinel-sign.


RESULTS
The subjective assessment showed that after the revision surgery, patients experienced load induced pain that occurred during daytime. However, the revision was able to improve the impaired sensibility. The functional outcome showed a persistent lack of strength when performing daily activities. The clinical assessment of the patients with relevant complaints confirmed the subjective outcome.


CONCLUSIONS
The revision surgery can improve the impaired sensibility, particularly, paresthesia nocturna. The persistent weakness of the hand can only partly be improved. In spite of remaining complaints, revision surgery can yield satisfactory results for the patients.
Unglaub
Frank
F
Handsurgery, Vulpiusklinik, Vulpiusstrasse 29, Bad Rappenau, Germany. Frank_Unglaub@web.de
Wolf
Elke
E
Goldbach
Claudia
C
Hahn
Peter
P
Kroeber
Markus W
MW
D000203:Activities of Daily Living; D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D010292:Paresthesia / Q000601:surgery; D017060:Patient Satisfaction; D010808:Physical Examination; D020127:Recovery of Function; D012086:Reoperation; D011795:Surveys and Questionnaires