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Home All Specialties Chronic Disease

Open carpal tunnel release provides long-term symptom relief

byAndrew Bishara
June 28, 2013
in Chronic Disease, Surgery
Reading Time: 3 mins read
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Image: PD 

1. In patients who underwent open carpal tunnel release (OCTR), 74% reported complete symptom resolution at 10 year follow-up.

2. At 10 year follow-up, 88% of patients were completely satisfied or very satisfied with the surgery. 

Study Rundown:  Strong functional, symptom, and satisfaction scores at 10 year follow-up demonstrate both the efficacy and durability of the open carpal tunnel release (OCTR) procedure.  Only 12% of patients reported the classic carpal tunnel symptom of nocturnal pain.  The high patient response rate of 72%(113/157) and the use of a validated questionnaire are marked strengths of this study.  It is however limited by a lack of preoperative symptom and dysfunction scores, prohibiting analyses to quantify improvement.  The study also lacks a control group.  Despite its limitations, this study serves to reinforce the excellent long-term outcomes of open carpal tunnel release.

Click to read the study in The Journal of Bone and Joint Surgery

Click to read an accompanying editorial in Journal

Relevant Reading: Carpal Tunnel Syndrome

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In-Depth [retrospective Cohort Study]:  The report included 113 patients who underwent open carpal tunnel release (OCTR) from 1996 to 2000 at a single institution by a single surgeon.  Patients were identified by ICD-9 billing codes and CPT procedural codes and were excluded if they underwent an additional procedure on the index hand or upper extremity, had an endoscopic carpal tunnel release (ECTR), refused participation, or were deceased.  If a patient underwent bilateral OCTR, only the first procedure was included.  Patient symptoms and function were evaluated by the Levine-Katz carpal tunnel instrument which employs a 5 point ordinal response scale (1 point = no pain, symptoms, or limitations. 5 points = severe pain, symptoms, limitations).  A score of greater than 2 was considered a poor symptom or function score.  Two additional questions were included to evaluate symptom resolution after one year and patient perception of the effect of surgery on their carpal tunnel symptoms.  The average time to follow-up was 13 years and the mean age at the time of surgery was 52 years ± 14.  The mean Levine-Katz symptom score was 1.3 ± 0.5, the mean function score was 1.6 ± 0.8. Of those reporting both pain and function scores, 42%(46/113) reported 1 for both indicating no symptoms or functional impairment.  By 1 year, 72% of patients reported complete symptom resolution and at 10 years, that increased to 74%.  The classic carpal tunnel symptom of nocturnal pain was reported by only 12% of patients.

By Chaz Carrier and Allen Ho

More from this author: Treating displaced femoral neck fractures: total hip arthroplasty (THA) found superior to open-reduction internal fixation (ORIF), Single level fusion provides equivalent outcomes to multilevel fusion for treating degenerative spondylolisthesis, Treating proximal humeral fractures: Reverse shoulder arthroplasty provides superior long term functional outcomes vs. hemiarthroplasty, Tendon transfer improves ankle function and reduces pain for chronic achilles tendinosis,4 million living with total knee replacement (TKR): First estimates of TKR burden in the US, Maternal factors increase odds of congenital vertebral malformations by 6x, MRI evidence of disc herniation is not predictive of clinical outcome in sciatica, Physical therapy equal to surgery for symptomatic meniscal tears 

© 2013 2minutemedicine.com. All rights reserved. No works may be reproduced without written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. Content is produced in accordance with fair use copyrights solely and strictly for the purpose of teaching, news and criticism. No benefit, monetary or otherwise, is realized by any participants or the owner of this domain. 

Tags: carpal tunneljointjoint surgeryprocedureSurgerysymptoms
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