title: Does carpal tunnel release provide long-term relief in patients with hemodialysis-associated carpal tunnel syndrome?
abstract: BACKGROUND
  Carpal tunnel syndrome (CTS) is a common complication in patients receiving long-term hemodialysis. In the short-term however, these patients are less likely to have pain relief and restoration of function after carpal tunnel release. However, it is unclear whether patients who have release for hemodialysis-associated CTS have differing persisting relief of symptoms compared with patients with idiopathic CTS.
  
  
  OBJECTIVE
  We therefore compared (1) the severity of pain and level of function in patients who had release for hemodialysis-associated CTS with scores of patients who had release for idiopathic CTS, and (2) the operation-related complications.
  
  
  METHODS
  We retrospectively reviewed 36 patients with CTS who were receiving hemodialysis and 54 patients with idiopathic CTS. Control subjects were matched for age, gender, and symptom severity. We obtained Boston Carpal Tunnel Questionnaire (BCTQ) scores preoperatively and at each followup. The minimum followup was 24 months (mean, 44.3 months; range, 24-90 months), although all comparisons were made at 2 years.
  
  
  RESULTS
  Two years after carpal tunnel release, the mean BCTQ-symptom (S) /BCTQ-function (F) scores improved from 3.3/2.1 to 2.1/2.1 in the hemodialysis-associated CTS group and from 3.2/2.3 to 1.4/1.4 in the idiopathic CTS group. All but six patients receiving hemodialysis had lower (better) BCTQ-S scores than their initial scores. Four patients had complications, all with hemodialysis-associated CTS: two had revision carpal tunnel releases and two had delayed wound healing. We observed no arteriovenous fistula-related complication.
  
  
  CONCLUSIONS
  Patients with hemodialysis-associated CTS seem to remain impaired, unlike patients with idiopathic CTS, but the majority of them might have much improved CTS-related symptoms at 2 years after carpal tunnel release.
authors.affiliation: Department of Orthopaedic Surgery, Yonsei University College of Medicine, 50 Yonseiro, Seodaemun-gu, Seoul 120-752, South Korea.
authors.forename: Ho Jung
authors.initials: HJ
authors.lastname: Kang
authors.forename: Il Hyun
authors.initials: IH
authors.lastname: Koh
authors.forename: Won Yong
authors.initials: WY
authors.lastname: Lee
authors.forename: Yun Rak
authors.initials: YR
authors.lastname: Choi
authors.forename: Soo Bong
authors.initials: SB
authors.lastname: Hahn
mesh_terms: D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D016009:Chi-Square Distribution; D019299:Decompression, Surgical / Q000009:adverse effects; D005260:Female; D006801:Humans; D008022:Ligaments / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects; D010146:Pain / Q000209:etiology / Q000601:surgery; D020127:Recovery of Function; D006435:Renal Dialysis / Q000009:adverse effects*; D056910:Republic of Korea; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome