Article
Effectiveness of operative treatment in chronic long-lasting carpal tunnel cases
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Published: | February 6, 2020 |
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Objectives/Interrogation: Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy. CTS diagnosis is usually based on physical examination. Tinel's and Phalen's tests are proved as high sensitive and specific. In the literature it is unclear what results can be expected and achieved in chronic cases. There is a doubt how much improvement the patients can get in cases with accompanying muscle atrophy and sensation deficits. The aim of the study was to assess patients clinical condition after operative treatment of chronic long-lasting carpal tunnel syndrome.
Methods: We examined 114 patients (93W, 21 M) average age 57 y.o. after long-lasting carpal tunnel syndrome (mean: 8 years) operative treatment were examined with Biometric grip strength dynamometer, 2PD test. Grip strength was examined with electronic Biometric dynamometer. Patients underwent clinical examination with basic tests confirming clinical condition (Tinel's and Phalen's tests). We used DASH, PRWE and BCTQ Questionnaire to assess patients condition.
Results and Conclusions: There was a significant difference (p<0,0001) between DASH results before and after surgery. DASH result before was decreased from 44,6 ± 18,9 to 16,1 ± 20,4. The PRWE result decreased significantly (p<0,0001) from 67,4 ± 38,2 to 10,9 ± 26,2. There were also significant increase (p=0,0002) of global grip strength from 15,9 ± 8,1 kg to 25,8 ± 9,6 kg. After surgery in BCTQ patients assess night wrist pain to 0,4 ± 0,8 and wrist pain during everyday living activities to 1,7 ± 1,2. There were no significant difference between 2PD test. Before surgery patients result was 6,2 ± 3,4 mm and after 5,4 ± 0,8.
Long lasting carpal tunnel syndrome influence patients everyday living activities and diminish hand function. The prolonged time of disease leads to a small decrease of fingers two-point discrimination and a significant decrease of grip strength.