Open carpal tunnel release--still a safe and effective operation.
BACKGROUND
Carpal tunnel syndrome is a common cause of neurological symptomatology. Surgical decompression remains the treatment of choice in patients not responding to conservative therapies. The aim of this study was to assess the effectiveness of standard open decompression by analysis of symptomatic and functional improvement and to assess whether a general surgeon can still perform this operation safely.


METHODS
Patients undergoing standard open carpal tunnel release by a single general surgeon were recruited. A self-administered Boston questionnaire was used to assess symptom severity and functional status pre- and post-surgical intervention.


RESULTS
Forty-seven patients (51 hands) underwent carpal tunnel release and 32 patients completed the questionnaire. 88% had a significant reduction in the symptom severity score, while improvement in function status score was achieved in 79% of patients. Mean symptom severity score improved from 3.41 points preoperatively to 1.85 (p < 0.0001) points at the last follow up examination, while the mean function status score improved from 2.73 to 1.99 points (p < 0.0001). Outcome was poor in six patients with slight worsening of either symptom or function status score. Three patients were treated conservatively for minor wound infection without long-term sequelae.


CONCLUSIONS
Standard open carpal tunnel release still provides efficacious symptomatic relief with a low risk of associated complications when performed by a general surgeon.
Badger
Stephen A
SA
Department of Surgery, Level 2, Belfast City Hospital Lisburn Road, Belfast BT9 7AB. stephenbadger@btinternet.com
O'Donnell
Mark E
ME
Sherigar
Jagannath M
JM
Connolly
Peter
P
Spence
Roy A J
RA
D002349:Carpal Tunnel Syndrome / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006304:Health Status; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D019637:Orthopedic Procedures; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D016896:Treatment Outcome