Abstract
The aim of this study was to evaluate the morbidity associated with carpal tunnel syndrome and the outcome following surgical treatment using the Nottingham Health Profile (NHP).
Between 1994 and 1996 we performed a prospective study of the effect of carpal tunnel release on the health status of 96 patients. The Nottingham Health Profile, a validated generic scoring system was used to assess quality of life, before and after surgery.
96 patients with 103 symptomatic hands were studied over this two year period. The patients completed a questionnaire before and 4 months after surgery. The notes were reviewed by an independent assessor and data collected with regard to duration and nature of symptoms, associated conditions, patients’ satisfaction and complications.
72 patients were satisfied with the results of surgery and 24patients were dissatisfied despite in the main clinical improvement. There was a significant improvement in the scores for pain, physical mobility and sleep 4 months following surgery in all patients.
We observed that those patients with a significantly high pre-op NHP score fared less well than cohorts, developing more frequent complications and overall were more likely to be dissatisfied with the results of surgery. This group of dissatisfied patients had previously been indistinguishable from their cohorts and were as it were invisible. The high NHP scores provided an objective way of identifying this group of individuals.
Carpal tunnel syndrome had a notable impact on the health status of our patients. There was a significant improvement in the NHP scores 4 months following surgery.
Our findings show that outcome assessment tools have predictive value in identifying patients who may not benefit from surgery or in whom a poor result might be anticipated.
The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom.
