INFLUENCE OF CERTAIN FACTORS IN THE OUTCOME OF THE SURGICAL CARPAL TUNNEL SYNDROME

Abstract

Objective: The purpose of this study was to determine which factors may influence in the outcome of the surgical treatment of Carpal Tunnel Syndrome (CTS).

Material and Methods: During 2005, 175 patients were treated with the diagnosis of CTS by open carpal release (short palmar incision) without ligament reconstruction. 113 cases were selected: 39 males and 74 females, with an average age of 41 years (21 to 64 years) and a follow-up of 24 months (12–36 months). The dominant hand was treated in 58%. The subcutaneous cellular tissue (SCT) was sutured in 14% and 11% were immobilized with a cast for 2 weeks after surgery.

We considered factors such as: systemic conditions, functional work requirement, preoperative time, surgical technique, and their correlation with complications, clinical outcome and time to return to work and activity level.

Results: Complications: 41% pillar pain, 9% suture dehiscence, 3,5% ulnar neuritis, 1,7% trigger finger, 1,7% reflex sympathetic dystrophy, and 1,8% wound infection. 5 patients were re-operated. Complications rate due to surgery was 3,5% after 12 months of follow-up. The average time out of work was 9 weeks (2–43 weeks) and was higher (13 weeks) in patients with post-operative immobilization. All patients, except one, returned to their previous activity level. History of systemic conditions and dominance had not influence on the final outcome. The suture of the SCT and the postoperative immobilization showed lower wound dehiscence and pillar pain cases.

Conclusions: The surgical treatment of the CTS provides good clinical and labour results. Patients with suture of the SCT and cast immobilization show less post-operative surgical complications.