What is the efficacy of surgical intervention for carpal tunnel syndrome (CTS)?

Updated: Mar 30, 2020
  • Author: Nigel L Ashworth, MBChB, MSc, FRCPC; Chief Editor: Milton J Klein, DO, MBA  more...
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Answer

A study by Rivlin et al found that in patients evaluated at 2 weeks and 3 months postoperatively, the efficacy of carpal tunnel release—as measured using the Quick Disabilities of the Arm, Shoulder and Hand questionnaire; symptom severity scale; and functional status scale—did not differ according to preoperative electrodiagnostic grade of CTS. [42]

A study by Rozanski et al indicated that in patients who have undergone isolated carpal tunnel release, the greatest risk factors for symptoms in the ambulatory surgery center or problems within 24 hours after discharge are as follows: male sex, age 45 years or above, and participation of an anesthesiologist in the procedure. However, all such symptoms or problems in the study, which were found in 10% of patients, were minor and transient, according to the investigators. The study involved the records of 400,000 adult patients with CTS, as contained in the National Survey of Ambulatory Surgery database, who underwent isolated carpal tunnel release. [43]

A retrospective study by Pace et al reported that among patients who underwent revision carpal tunnel surgery, self-reported symptom severity and functional scores were the same between patients who underwent repeat decompression alone (17 hands) and those who underwent a combination of decompression and hypothenar fat pad transposition (16 hands). [44]


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