Long-Term Functional Outcomes of Open Carpal Tunnel Release Surgery
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Published:
Oct 10, 2021
Keywords:
Carpal Tunnel Syndrome, Electromyography, Muscle Strength Dynamometer, Hand Strength, Operative Surgical Procedures, Treatment Result
Main Article Content
Abstract
Introduction: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy that causes compression of the median nerve. Open median nerve release surgery plays an important role, especially in patients with failed conservative management or with a diagnosis of severe CTS. The purpose of the following study is to describe the functional outcomes, satisfaction, and objective strength in the medium (6 to 24 months) and long term (greater than 24 months) with the conventional open technique in the local population.
Materials and Methods: Descriptive observational study based on retrospective data of functional clinicaloutcomes in the medium and long term in patients undergoing open release surgery of the median nerve as a treatment for CTS. Functional level according to BCTQ and FSS, grip strength with an electronic dynamometer, and satisfaction were determined.
Results: 100 procedures were performed between May 2012 and September 2018, with a follow-up of more than 6 months. The majority were women (83%) with a total median age of 59 years showing good to excellent outcomes in the 97% in the medium term and 90% in the long term, with a median strength of 17 kg (Interquartile range: 7.4) and satisfaction of 90 (Interquartile range: 20).
Conclusions: Open surgery to release the median nerve in patients with CTS shows good to excellent functional outcomes, satisfaction, and strength in the medium and long term.
Materials and Methods: Descriptive observational study based on retrospective data of functional clinicaloutcomes in the medium and long term in patients undergoing open release surgery of the median nerve as a treatment for CTS. Functional level according to BCTQ and FSS, grip strength with an electronic dynamometer, and satisfaction were determined.
Results: 100 procedures were performed between May 2012 and September 2018, with a follow-up of more than 6 months. The majority were women (83%) with a total median age of 59 years showing good to excellent outcomes in the 97% in the medium term and 90% in the long term, with a median strength of 17 kg (Interquartile range: 7.4) and satisfaction of 90 (Interquartile range: 20).
Conclusions: Open surgery to release the median nerve in patients with CTS shows good to excellent functional outcomes, satisfaction, and strength in the medium and long term.
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How to Cite
Rojas Duque , G., González, C. J., Torres Mayorga, A., Hernández Ramírez , R. A., & Muñoz Medina, S. E. (2021). Long-Term Functional Outcomes of Open Carpal Tunnel Release Surgery. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 86(5), 601-612. https://doi.org/10.15417/issn.1852-7434.2021.86.5.1305
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Clinical Research
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2. Genova A, Dix O, Saefan A, Thakur M, Hassan A. Carpal tunnel syndrome: a review of literature. Cureus
2020;12(3):e7333. https://doi.org/10.7759/cureus.7333
3. Thomsen JF, Gerr F, Atroshi I. Carpal tunnel syndrome and the use of computer mouse and keyboard: a systematic review. BMC Musculoskelet Disord 2008;9:134. https://doi.org/10.1186/1471-2474-9-134
4. Lozano-Calderón S, Anthony S, Ring D. The quality and strength of evidence for etiology: example of carpal tunnel syndrome. J Hand Surg Am 2008;33(4):525-38. https://doi.org/10.1016/j.jhsa.2008.01.004
5. Palumbo CF, Szabo RM. Examination of patients for carpal tunnel syndrome sensibility, provocative, and motor
testing. Hand Clin 2002;18(2):269-77. https://doi.org/10.1016/S0749-0712(01)00007-5
6. Keith MW, Masear V, Chung K, Maupin K, Andary M, Amadio PC, et al. Diagnosis of carpal tunnel syndrome. J
Am Acad Orthop Surg 2009;17(6):389-96. https://doi:10.5435/00124635-200906000-00007
7. Durkan JA. A new diagnostic test for carpal tunnel syndrome. J Bone Joint Surg Am 1991;73(4):535-8. Erratum in: J Bone Joint Surg Am 1992;74(2):311. PMID: 1796937
8. Chammas M, Boretto J, Burmann LM, Ramos RM, Dos Santos Neto FC, Silva JB. Carpal tunnel syndrome - Part I
(anatomy, physiology, etiology and diagnosis). Rev Bras Ortop 2014;49(5):429-36. https://doi.org/10.1016/j.rboe.2014.08.001
9. Sonoo M, Menkes DL, Bland JDP, Burke D. Nerve conduction studies and EMG in carpal tunnel syndrome: Do
they add value? Clin Neurophysiol Pract 2018;3:78-88. https://doi.org/10.1016/j.cnp.2018.02.005
10. Chammas M, Boretto J, Burmann LM, Ramos RM, Neto FS, Silva JB. Carpal tunnel syndrome - Part II (treatment). Rev Bras Ortop 2014;49(5):437-45. https://doi.org/10.1016/j.rboe.2014.08.002
11. Atroshi I, Hofer M, Larsson GU, Ranstam J. Extended follow-up of a randomized clinical trial of open vs
endoscopic release surgery for carpal tunnel syndrome. JAMA 2015;314(13):1399-401.
https://doi.org/10.1001/jama.2015.12208
12. Vasiliadis HS, Georgoulas P, Shrier I, Salanti G, Scholten RJ. Endoscopic release for carpal tunnel
syndrome. Cochrane Database Syst Rev 2014;1:CD008265. https://doi.org/10.1002/14651858.CD008265.pub2
13. Sayegh ET, Strauch RJ. Open versus endoscopic carpal tunnel release: a meta-analysis of randomized controlled trials. Clin Orthop Relat Res 2015;473(3):1120-32. https://doi.org/10.1007/s11999-014-3835-z
14. Michelotti B, Romanowsky D, Hauck RM. Prospective, randomized evaluation of endoscopic versus open carpal tunnel release in bilateral carpal tunnel syndrome: an interim analysis. Ann Plast Surg 2014;73(2):S157-S160. https://doi.org/10.1097/SAP.0000000000000203
15. Domínguez A, Mira LL, Sallent A, Seijas R, Escalona C, Cugat R, et al. Short-term outcomes after median nerve
release for carpal tunnel syndrome. Intern J Orthop 2017;4(3):758-62. https://doi.org/10.17554/j.issn.2311-5106.2017.04.214
16. Ishida K, Matsumoto T, Tsumura N, Kubo S, Kitagawa A, Chin T, et al. Mid-term outcomes of computer-assisted total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2011;19(7):1107-12.
https://doi.org/10.1007/s00167-010-1361-4
17. Louie D, Earp B, Blazar P. Long-term outcomes of carpal tunnel release: a critical review of the literature. Hand (N Y) 2012;7(3):242-6. https://doi.org/10.1007/s11552-012-9429-x
18. Kouyoumdjian JA, Morita MPA, Molina AFP, Zanetta DMT, Sato AK, Rocha CED, et al. Long-term outcomes of
symptomatic electrodiagnosed carpal tunnel syndrome. Arq Neuro Psiquiatr 2003;61(2A):194-8.
https://doi.org/10.1590/S0004-282X2003000200007
19. Tang CQY, Lai SWH, Tay SC. Long-term outcome of carpal tunnel release surgery in patients with severe carpal tunnel syndrome. Bone Joint J 2017;99-B(10):1348-53. https://doi.org/10.1302/0301-620X.99B10.BJJ-2016-0587.R2
20. Oteo-Álvaro Á, Marín MT, Matas JA, Vaquero J. Validación al castellano de la escala Boston Carpal Tunnel
Questionnaire. Med Clin (Barc) 2016;146(6):247-53. https://doi.org/10.1016/j.medcli.2015.10.013