An assessment of symptomatic relief after carpal tunnel release in patients on haemodialysis.

UNLABELLED: Patients receiving haemodialysis for chronic kidney disease are at risk of developing beta(2)-microglobulin-related carpal tunnel syndrome (CTS). There is a lack of evidence regarding outcome of this complication following surgical treatment. The current study specifically addressed the relief of symptoms after carpal tunnel release in this particular group of patients.

MATERIALS AND METHOD: 26 carpal tunnel release operations were performed in 19 patients (12 males, 7 females) between 1992 and 1996. The mean age of the patients was 59 years (range 41-78) with a mean duration of haemodialysis of 12.6 years. Patients were dialysed the day before surgery with low-dose heparin. All procedures were performed using 1% Xylocaine with adrenaline 1:200,000 without tourniquet as day cases. Relief of weakness of the hand, tingling, pain at rest, pain on use, nocturnal paraesthesiae and scar pain were assessed.

RESULTS

All outcome measures showed marked improvement and 84% (16/19) of patients were satisfied with the outcome. One patient showed worsening of pain at rest and pain on use of hand.

CONCLUSION

Release of carpal tunnel in patients on haemodialysis helps alleviation of symptoms due to median nerve compression and improves the function of hand and quality of life in the majority of patients. There can still be a small minority of patients who may not show any improvement and a few may rarely get worse.