Clinical features influencing the patient-based outcome after carpal tunnel release.

PURPOSE: We analyzed several clinical features of carpal tunnel syndrome to identify potential prognostic factors influencing a patient-based outcome assessment after carpal tunnel release.

METHODS

We evaluated 102 hands of 64 patients with carpal tunnel syndrome using the Boston self-assessment questionnaire preoperatively and 3, 6, 9, and 12 months postoperatively. The clinical findings evaluated as prognostic indicators were paresthesia, cold intolerance, subjective weakness, nocturnal pain, thenar atrophy, Tinel sign, Phalen test, and electrophysiologic grades. All assessments of outcome were subjective based on the reports of patients, and no objective measurements were obtained to establish improvement after surgery.

RESULTS

The overall symptom and functional scales of the self-assessment questionnaire demonstrated a significant improvement at 3 months after surgery, but no significant further improvement was observed thereafter. Patients with nocturnal pain, patients without subjective weakness, and patients without cold intolerance demonstrated more improvement of the scores in the bivariate analysis.

CONCLUSIONS

This information may be used in preoperative consultation regarding the outcome of surgery from the patient's perspective.

TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.