Carpal tunnel release in patients with diabetes result in poorer outcome in long-term study.
BACKGROUND
The aim of this prospective study was to compare the results of surgical decompression of carpal tunnel syndrome (CTS) in patients with diabetes mellitus with those with idiopathic CTS.


METHODS
The results of surgical decompression of CTS in 27 patients with diabetes mellitus were compared with 42 patients with idiopathic CTS. All patients underwent surgical release of transverse carpal ligament by the mini-incision of palm technique. Patient self-administered Boston Questionnaire (BQ) for the assessment of severity of CTS symptoms and hand functional status was evaluated before and 6 months and 10 years after surgery.


RESULTS
After surgical release, all the patients of both groups reported an absence of pain, disappearance or reduction of paresthesia, and improvement in hand function. Six months after surgery, there was a significant improvement of symptomatic and functional BQ scores compared with preoperative state in both groups. Ten years after surgery, there was statistical difference in preoperative and postoperative 10th year functional BQ score between DM (-) and DM (+) (p < 0.01). DM status affected statistically functional BQ score between preoperative and postoperative 10th year.


CONCLUSIONS
Diabetes mellitus was a risk factor for poor outcome of surgical decompression of CTS. Patients with diabetes had worse surgical outcome compared with patients with idiopathic CTS in long-term follow-up.
Orthopaedic and Traumatology Department, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Semsi Denizer Cad. E5. Yanyol Cevizli Kavsagı Kartal, Istanbul, 34890, Turkey, dgulabi@yahoo.com.
Deniz
D
Gulabi
Gultekin
G
Cecen
Bulent
B
Guclu
Aycicek
A
Cecen
D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D019299:Decompression, Surgical; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D010292:Paresthesia / Q000209:etiology*; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome