Splinting after carpal tunnel release: current practice, scientific evidence, and trends.

BACKGROUND

Postoperative splinting is common after carpal tunnel release, despite a lack of scientific evidence supporting its value. The purpose of this study was to characterize postoperative splinting regimens among hand surgeons and to identify trends in splint use after this procedure.

METHODS

Questionnaires were mailed to members of the American Society for Surgery of the Hand. Recipients were asked to record whether and for how long they use splints after carpal tunnel release. They were also asked to indicate their training (i.e., orthopedic, plastic, or general surgery). Results were compared with those of previously conducted surveys.

RESULTS

One thousand ninety-one questionnaires were returned, for a response rate of 48 percent. Fifty-three percent of respondents use splinting postoperatively. Duration of splinting varied tremendously, from 1 to 42 days. Splinting patterns were similar across all training backgrounds. In comparison with related surveys conducted in 1987 and 1997, a trend is evident toward less use of splinting after carpal tunnel release.

CONCLUSIONS

The use and duration of splinting after carpal tunnel release vary widely among hand surgeons. This divergence of practice implies that there is little therapeutic benefit to splinting after this procedure, a concept supported by substantial scientific evidence and by a trend away from splinting over the past 20 years.