Outcomes of open carpal tunnel decompression

Nanavati, N., Walker-Bone, K., Stanworth, H. and Williams, C. (2013) Outcomes of open carpal tunnel decompression. New Zealand Medical Journal, 126 (1369), 60-67. (PMID:23463111)

Abstract

BACKGROUND: Carpal tunnel syndrome (CTS) is the commonest peripheral neuropathy in the UK. The aim of this study was to characterise the satisfaction and evaluate the symptoms of postoperative patients having undergone open carpal tunnel decompression.

METHOD: A questionnaire comprising of 6 sections was sent to 241 eligible participants. Subjects were asked to provide their demographic information and to quantify preoperative and postoperative numbness and tingling. The target population was also asked to indicate areas of postoperative numbness and tingling on a Katz hand diagram. Symptom severity and quality of life scores were also assessed.

RESULTS: This study received 89 usable responses. From analysis of the Katz hand diagrams if was possible to distinguish that 17 subjects (19.1%) had 'persistent' symptoms following carpal tunnel decompression and 72 subjects (80.9%) showed signs of symptomatic improvement. The 17 individuals with persistent symptoms were further assessed for significance between variables. Of these, most were of older age, mainly female, unemployed, with lower mental health and vitality scores. With significance testing, it was shown that lower mental health scores may contribute to a poorer response to surgery (p=0.096).

CONCLUSION: Most subjects experienced a positive response to surgical intervention, however, it may be necessary to screen patients for signs of depression before undertaking any surgery. By taking a more holistic preoperative assessment and aiding patients to seek treatment for any mental health conditions, this study postulates that outcomes of open carpal decompression could be improved.

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Contributors

Author: K. Walker-Bone

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