Abstract
Rationale Carpal tunnel syndrome (CTS) is the most frequently encountered compressive neuropathy
of the upper limb. The treatment of CTS ranges from conservative management to carpal
tunnel release. Many patients with misconception about the potential morbidity and
with the hope of successful conservative treatment delay the surgical release of carpal
tunnel. This delay results in reduced recovery of sensory and motor median nerve function.
Objective The aim of this study was to evaluate the influence of preoperative duration and
severity of symptom on the outcome of carpal tunnel surgery.
Method It included 45 cases of CTS, all treated with limited access open carpal tunnel release.
The duration of symptoms (i.e., pain, numbness, tingling, waking up at night because
of pain/numbness, difficulty in grasping small objects, and their preoperative severity)
was noted using Boston CTS questionnaire. To investigate the outcome, patients were
divided into three groups based on their duration of symptoms.
Result Group1: The severity of symptoms was reduced to normal in a short period of time
in patients who presented with duration of symptoms less than 6 months. Group 2: Patients
in whom symptoms lasted for 6 to 12 months had reduced or delayed recovery of hand
function as compared with first group. Group 3: Patients who had symptoms for more
than 12 months had incomplete recovery of grip strength. Return to normal function
took the longest time (median: 16 weeks) in this group.
Conclusion This study suggests that patients who present late have delayed/incomplete relief
of symptoms after carpal tunnel release.
Keywords
carpal tunnel release - carpal tunnel syndrome - severity of symptoms - duration of
symptoms
