title: A prospective, longitudinal outcome study of patients with carpal tunnel surgery and the relationship of body mass index.
abstract: This study investigated whether body mass index (BMI) was associated with effectiveness of carpal tunnel release as measured by physical and self-assessment tests. This prospective, longitudinal study was conducted from March 2001 to March 2003 using 598 cases (hands) diagnosed with carpal tunnel syndrome and scheduled for surgery at The Curtis National Hand Center, Baltimore, Maryland, and at the Pulvertaft Hand Centre, Derby, England. Body mass index was calculated, and demographic, clinical, and functional data were collected preoperatively and at 6-month follow-up. Grip, pinch, and Semmes-Weinstein scores were measured preoperatively and at 6-month follow-up. Levine-Katz self-assessment scores for symptom severity and functional status were measured preoperatively and at 6-month follow-up. Grip and pinch increased, whereas Semmes-Weinstein, symptom severity, and functional scores decreased by 6-month follow-up. Cases with BMI >35 had lower grip strength and higher symptom severity in males and higher functional status in both sexes pre- and postoperatively compared to normal-weight BMI cases. BMI had no relationship to patient satisfaction. Although morbidly obese cases did worse on some physical and self-assessment tests compared to normal BMI cases preoperatively, all improved to the same extent postoperatively regardless of BMI.
authors.affiliation: The Curtis National Hand Center, Union Memorial Hospital, 3333 N. Calvert Street, #200, Baltimore, MD, 21218, USA.
authors.forename: Venkata Krishna Rao
authors.initials: VK
authors.lastname: Bodavula
authors.forename: Frank D
authors.initials: FD
authors.lastname: Burke
authors.forename: Norman H
authors.initials: NH
authors.lastname: Dubin
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Bradley
authors.forename: E F Shaw
authors.initials: EF
authors.lastname: Wilgis
references.citation: J Hand Surg Am. 1996 May;21(3):338-46
references.pmid: 8724457
references.citation: J Surg Orthop Adv. 2004 Winter;13(4):206-9
references.pmid: 15691181
references.citation: J Hand Surg Br. 2005 Dec;30(6):593-8
references.pmid: 16129527
references.citation: J Med Assoc Thai. 1999 Feb;82(2):182-5
references.pmid: 10087727
references.citation: JAMA. 1999 Jul 14;282(2):153-8
references.pmid: 10411196
references.citation: Clin Neurophysiol. 2002 Sep;113(9):1429-34
references.pmid: 12169324
references.citation: J Neurol Neurosurg Psychiatry. 2003 Dec;74(12):1674-9
references.pmid: 14638888
references.citation: J Bone Joint Surg Am. 1993 Nov;75(11):1585-92
references.pmid: 8245050
references.citation: Instr Course Lect. 1995;44:167-72
references.pmid: 7797856
references.citation: Am J Ind Med. 1997 Nov;32(5):550-6
references.pmid: 9327082
references.citation: Ann Plast Surg. 2002 Mar;48(3):269-73
references.pmid: 11862031
references.citation: World Health Organ Tech Rep Ser. 2003;916:i-viii, 1-149, backcover
references.pmid: 12768890
references.citation: Evid Rep Technol Assess (Summ). 2002 Oct;(62):1-12
references.pmid: 12526186
references.citation: Muscle Nerve. 1994 Jun;17(6):632-6
references.pmid: 8196706
references.citation: Arq Neuropsiquiatr. 2000 Jun;58(2A):252-6
references.pmid: 10849623