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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(04): e504-e509
DOI: 10.1055/s-0044-1785665
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Wrist Immobilization after Surgical Decompression of the Median Nerve in Carpal Tunnel Syndrome: A Systematic Review

Article in several languages: português | English
Thiago Moreth da Silva Barbosa 
1   Departamento de Ortopedia e Traumatologia, Hospital Getúlio Vargas, Recife, PE, Brasil
,
Ítalo Carvalho Ferraz
1   Departamento de Ortopedia e Traumatologia, Hospital Getúlio Vargas, Recife, PE, Brasil
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Financial Support The authors declare that this study received no financial support from public, commercial, or non-profit sources.
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Abstract

Objective The most common compressive neuropathy of the upper limbs is carpal tunnel syndrome (CTS). Historically, there has been a tendency to apply immobilization in the postoperative period, a practice that has decreased in recent years. This review aims to assess whether there is scientific evidence to justify the use of immobilization in the postoperative care of CTS decompression.

Methods The following databases were used: Biblioteca Virtual em Saúde (BVS), PubMed National Library of Medicine – (NLM), Cochrane Library, Scientific Electronic Library Online (SciELO), and EMBASE. The following inclusion criteria were used: 1) discussion of the postoperative period of median nerve decompression surgery in CTS; 2) comparison of results after surgical decompression in CTS between wrist immobilization or local dressing; 3) all languages, regardless of the year of publication; and 4) all types of publications. The following exclusion criteria were used: 1) studies that did not evaluate the postoperative period of CTS decompression; 2) lack of evaluation of the outcome related to the application of local dressing or some form of wrist immobilization after the surgical decompression procedure; and 3) repeated publications.

Results The literature search resulted in 336 relevant publications. In the end, 18 publications were chosen. Systematic reviews, randomized clinical trials, and cross-sectional studies were found.

Conclusions Due to the scarcity of evidence supporting the use of immobilization coupled with the higher costs associated with the practice, it has become less and less frequent in recent decades.

Clinical relevance In the literature, two approaches to postoperative care for CTS decompression are described: immobilization or just local dressing. According to the available scientific evidence, it is worth evaluating which one is better.

Keywords

carpal tunnel syndrome - median nerve - peripheral nerve injuries - wrist injuries

Work carried out at the Getúlio Vargas Hospital, Recife, PE, Brazil.




Publication History

Received: 10 November 2023

Accepted: 15 January 2024

Article published online:
19 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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