The Association Between Bariatric Surgery and Surgical Outcomes Following Open Carpal Tunnel Release.

INTRODUCTION

While previous research has evaluated surgical outcomes following open carpal tunnel release (CTR) in obese patients, there is relatively minimal literature regarding outcomes in patients who have previously undergone bariatric surgery prior to open CTR. The purpose of this study is to compare the postoperative functional and surgical outcomes in patients who undergo open CTR with or without a history of bariatric surgery.

METHODS

Adult patients with a documented history of bariatric surgery undergoing open CTR surgery between 2015 and 2022 were propensity matched with control open CTR patients with no bariatric surgery history. Patients were matched based on age, sex, race, body mass index (BMI), Charlson Comorbidity Index (CCI), smoking status, and history of diabetes mellitus. A retrospective chart review was performed to collect demographic data, preoperative nerve conduction studies (NCS), surgical characteristics, complications, further treatment, and patient-reported outcome measures (PROMs).

RESULTS

A total of 42 patients having undergone bariatric surgery prior to CTR and 84 control CTR patients with no history of bariatric surgery were included. More bariatric surgery patients demonstrated mild carpal tunnel syndrome (CTS) on preoperative NCS. The overall minor complication rate was similar between patients with and without bariatric surgery history. There were no differences in postoperative Physical Component score (PCS-12) and Mental Component score (MCS-12) as well as no change in PCS-12 scores (ΔPCS-12) between preoperative and one-year postoperative scores.

CONCLUSIONS

Patients with a history of bariatric surgery tended to have a larger benefit from open CTR in comparison to the control cohort; however, this was not statistically significant. The current literature regarding CTR outcomes as it relates to obesity and bariatric surgery is limited, and therefore, the association should be explored further with larger patient cohorts.