title: Outcome after carpal tunnel release: impact of factors related to metabolic syndrome.
abstract: OBJECTIVE
  The standard surgical treatment of carpal tunnel syndrome (CTS), with an open carpal tunnel release, is reported to relieve symptoms in most patients. In a retrospective observational study, outcome after open carpal tunnel release was evaluated, focusing on factors related to the metabolic syndrome: diabetes, hypertension, obesity (BMI ≥30) and statin treatment.
  
  
  METHODS
  Results from 493 out of 962 patients (531/1044 hands) operated for CTS during 18 months that had filled in QuickDASH questionnaires before and 1-year after surgery were included in the study.
  
  
  RESULTS
  Patients with diabetes (n = 76) had higher QuickDASH scores pre- (56 [36-77]; i.e. median [interquartile range]) and postoperatively (31 [9-61]) compared to patients without diabetes (48 [32-66]; p < 0.05 and 16 [5-43]; p < 0.001), but the change in total score was equal. A higher proportion of patients with diabetes had a postoperative score of >10 (74% vs 61%; p < 0.05). The odds of having a change in QuickDASH score <8 was 2.6-times higher in patients with polyneuropathy than in patients without polyneuropathy. Patients with hypertension, obesity, or statin treatment had a similar improvement after surgery as patients without these factors.
  
  
  CONCLUSIONS
  Patients with diabetes without neuropathy, as well as patients with hypertension, obesity or statin treatment, and CTS can expect the same effects of open carpal tunnel release as otherwise healthy patients. Patients with diabetic neuropathy and CTS did not experience the same improvement as otherwise healthy patients and should be informed about the risk of an unsatisfactory outcome.
authors.affiliation: a Department of Hand Surgery , Skåne University Hospital, Lund University , Malmö , Sweden.
authors.forename: Malin
authors.initials: M
authors.lastname: Zimmerman
authors.affiliation: a Department of Hand Surgery , Skåne University Hospital, Lund University , Malmö , Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Dahlin
authors.affiliation: a Department of Hand Surgery , Skåne University Hospital, Lund University , Malmö , Sweden.
authors.forename: Niels O B
authors.initials: NOB
authors.lastname: Thomsen
authors.affiliation: b Department of Neurophysiology , Skåne University Hospital, Lund University , Malmö , Sweden.
authors.forename: Gert S
authors.initials: GS
authors.lastname: Andersson
authors.affiliation: a Department of Hand Surgery , Skåne University Hospital, Lund University , Malmö , Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Björkman
authors.affiliation: a Department of Hand Surgery , Skåne University Hospital, Lund University , Malmö , Sweden.|c Department of Translational Medicine - Hand Surgery , Lund University and Skåne University Hospital , Malmö , Sweden.
authors.forename: Lars B
authors.initials: LB
authors.lastname: Dahlin
mesh_terms: D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D003920:Diabetes Mellitus / Q000453:epidemiology; D003929:Diabetic Neuropathies / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D063868:Patient Outcome Assessment; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Carpal tunnel syndrome; diabetic neuropathy; hypertension; metabolic syndrome; obesity; open carpal tunnel release; statins