Natural History of Constant Preoperative Fingertip Numbness and Thenar Atrophy Following Carpal Tunnel Release: A Prospective Study

Abstract

Background

It is not well known whether constant fingertip numbness (CN) or thenar muscle atrophy in advanced carpal tunnel syndrome (CTS) improves following carpal tunnel release (CTR).

Materials and Methods

A total of 41 hands from 36 patients were enrolled in this prospective study. Patients endorsed CN (n = 38) and/or presented on physical exam with thenar atrophy (TA; n = 18); 12 patients had both. After undergoing open CTR, patients were evaluated at 8 days, 3, 6, and 12 months following surgery. Outcomes assessed included Semmes–Weinstein sensibility, grip strength, key-pinch strength, QuickDash scores, and atrophy via direct quantitative measurement.

Results

Six months postoperative, 83% of CN patients showed improved sensibility in any digit versus 40% of TA patients. Pinch strength was worse at baseline in TA patients (8.9 ± 3.7 vs. 10.8 ± 5.0) and returned to baseline in 72 and 80% of CN and TA patients at 6 months and 93.3 and 100% of CN and TA patients at 12 months. Hand function dissatisfaction improved to 100% satisfaction at 3 months. Tingling severity was characterized as “none” from zero patients at baseline to 42, 72, and 62% of all patients at 3, 6, and 12 months. Atrophy patients presented with 1.4 ± 0.8 mm of atrophy at baseline that improved by 1.2 mm at 12 months.

Conclusion

Patients with TA showed weaker pinch strengths at baseline but improved more rapidly than CN patients. Hand function significantly improved by 3 months and constant tip numbness resolved in roughly 2/3 of all patients at 6 months.

Keywords

carpal tunnel syndrome - constant numbness - thenar atrophy

Patients' Consent

Informed consent was obtained from all individual participants included in the study.

State of Human and Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all patients to be included in the study.

Publikationsverlauf

Eingereicht: 10. Dezember 2024

Angenommen: 13. März 2025

Artikel online veröffentlicht:
28. April 2025

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