Evaluation of Symptoms after Surgical Release of the Carpal Tunnel in Patients Operated on in the last 10 Years in a Tertiary Academic Hospital

Authors

  • Guilherme Martins Nanci Médico Residente em Cirurgia da Mão, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (HC-FMRP-USP), 14040-906 Ribeirão Preto - SP, Brasil https://orcid.org/0000-0001-6503-8227
  • Otávio Rosa Kempf Médico Residente em Ortopedia e Traumatologia, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (HC-FMRP-USP), 14040-906 Ribeirão Preto - SP, Brasil https://orcid.org/0009-0008-1689-7867
  • Venâncio Veneroni Martins Médico Residente em Ortopedia e Traumatologia, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (HC-FMRP-USP), 14040-906 Ribeirão Preto - SP, Brasil https://orcid.org/0000-0001-6000-516X
  • Lucas Klarosk Ismael Médico Residente em Ortopedia e Traumatologia, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (HC-FMRP-USP), 14040-906 Ribeirão Preto - SP, Brasil https://orcid.org/0000-0002-4185-1931
  • Vitor Araújo Gonçalves Doutorando, Programa de Pós-Graduação em Ciências da Saúde Aplicadas ao Aparelho Locomotor da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP); Residente em Cirurgia da Coluna, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (HC-FMRP-USP), 14040-906 Ribeirão Preto - SP, Brasil https://orcid.org/0000-0003-3008-8843
  • Cícero José Silva Souto Graduando, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), 14040-906 Ribeirão Preto - SP, Brasil https://orcid.org/0009-0006-7260-0461
  • Luis Guilherme Rosifini Alves Rezende Professor Doutor, Programa de Pós-Graduação em Ciências da Saúde Aplicadas ao Aparelho Locomotor da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP); Responsável pela Residência Médica, pelo Grupo e Divisão de Cirurgia da Mão, Microcirurgia e Cirurgia do Membro Superior, Departamento de Ortopedia e Anestesiologia, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (HC-FMRP-USP), Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP) 14040-906 Ribeirão Preto - SP, Brasil https://orcid.org/0000-0002-2037-0135

DOI:

https://doi.org/10.21270/archi.v13i10.6486

Keywords:

Carpal Tunnel Syndrome, Nerve Compression Syndromes, Median Nerve, Wrist

Abstract

Objective: To retrospectively evaluate the comorbidities and symptoms of patients undergoing surgical release of carpal tunnel syndrome in a tertiary academic hospital in the last decade, describing clinical and demographic data and the occurrence of postoperative complications. Methods: The project was approved by the Human Research Ethics Committee, under protocol number CAAE 79061724.4.0000.5440. All medical records used in the research were made available by our institution. We requested a waiver of the informed consent form (ICF) due to the impossibility of contacting the large number of participants. Results: Of all 325 patients who underwent surgical release for CTS, 71 presented symptoms in the postoperative period, with some of the symptoms that have persisted since before surgery. Pillar pain was the most common complication, while infections and dehiscence had a low occurrence. Complications were more prevalent in patients with more than 1 comorbidity. Hypertension, diabetes, and obesity remained highly prevalent. Conclusion: The prevalence of patients with symptoms after surgical release of the median nerve in the carpal tunnel was 21%. Women were more affected, and the mean age was 50 years. Pilar pain was the most prevalent symptom.

Downloads

Download data is not yet available.

References

Genova A, Dix O, Saefan A, Thakur M, Hassan A. Carpal Tunnel Syndrome: A Review of Literature. Cureus. 2020;12(3):e7333.

Middleton SD, Anakwe RE. Carpal tunnel syndrome. BMJ. 2014;349:g6437.

Newington L, Harris EC, Walker-Bone K. Carpal tunnel syndrome and work. Best Pract Res Clin Rheumatol. 2015 Jun;29(3):440-53. doi:

Chammas M. Carpal tunnel syndrome. Chir Main. 2014 Apr;33(2):75-94.

Barbieri CH. Sindrome do tunel do carpo - tratamento cirurgico. Rev Bras Neurol. 1991;27(1): 395-425.

Verdugo RJ, Salinas RS, Castillo J, Cea JG. Surgical versus non-surgical treatment for carpal tunnel syndrome. Cochrane Database Syst Rev. 2003;(3):CD001552.

A Sousa LH, O Costa C, Novak EM, Giostri GS. Complex Regional Pain Syndrome after Carpal Tunnel Syndrome Surgery: A Systematic Review. Neurol India. 2022 Mar-Apr;70(2):491-503

Jones NF, Ahn HC, Eo S. Revision surgery for persistent and recurrent carpal tunnel syndrome and for failed carpal tunnel release. Plast Reconstr Surg. 2012 Mar;129(3):683-692.

Stütz N, Gohritz A, van Schoonhoven J, Lanz U. Revision surgery after carpal tunnel release--analysis of the pathology in 200 cases during a 2 year period. J Hand Surg Br. 2006;31(1):68-71.

Lafon L, Lautman S, Corcia P, Laulan J. Compressions du nerf médian dans la région du coude et de la partie proximale de l'avant-bras. À propos d'une série de 35 cas consécutifs [Proximal median nerve compression. A series of 35 consecutive cases]. Chir Main. 2013;32(3):147-53.

Dahlin LB, Zimmerman M, Calcagni M, Hundepool CA, van Alfen N, Chung KC. Carpal tunnel syndrome. Nat Rev Dis Primers. 2024;10(1):37.

Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, Caliandro P, Hobson-Webb LD. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol. 2016;15(12):1273-1284.

Napper AD, Sayal MK, Holmes MWR, Cudlip AC. Sex differences in wrist strength: a systematic review. PeerJ. 2023;11:e16557.

Lane JCE, Craig RS, Rees JL, Gardiner MD, Green J, Prieto-Alhambra D, Furniss D. Serious postoperative complications and reoperation after carpal tunnel decompression surgery in England: a nationwide cohort analysis. Lancet Rheumatol. 2020;3(1):e49-e57.

Giannakopoulos, P., Kourkoutas, K., Kasimatis, G. (2020). Complications of Carpal Tunnel Release. In: Sotereanos, D., Papatheodorou, L. (eds) Compressive Neuropathies of the Upper Extremity. Springer, Cham.

Divo MJ, Martinez CH, Mannino DM. Ageing and the epidemiology of multimorbidity. Eur Respir J. 2014;44(4):1055-68.

Guan W, Lao J, Gu Y, Zhao X, Rui J, Gao K. Case-control study on individual risk factors of carpal tunnel syndrome. Exp Ther Med. 2018;15(3):2761-766.

Lampainen K, Hulkkonen S, Ryhänen J, Curti S, Shiri R. Is Smoking Associated with Carpal Tunnel Syndrome? A Meta-Analysis. Healthcare (Basel). 2022;10(10):1988.

Park D, Lee SE, Cho JM, Yang JW, Kim M, Kwon HD. Characteristics of diabetic and non-diabetic carpal tunnel syndrome in terms of clinical, electrophysiological, and Sonographic features: a cross-sectional study. BMC Musculoskelet Disord. 2023;24(1):739.

Wiberg A, Smillie RW, Dupré S, Schmid AB, Bennett DL, Furniss D. Replication of epidemiological associations of carpal tunnel syndrome in a UK population-based cohort of over 400,000 people. J Plast Reconstr Aesthet Surg. 2022;75(3):1034-1040.

Low J, Kong A, Castro G, Rodriguez de la Vega P, Lozano J, Varella M. Association Between Diabetes Mellitus and Carpal Tunnel Syndrome: Results From the United States National Ambulatory Medical Care Survey. Cureus. 2021;13(3):e13844.

Sanjari E, Raeisi Shahraki H, G Khachatryan L, Mohammadian-Hafshejani A. Investigating the association between diabetes and carpal tunnel syndrome: A systematic review and meta-analysis approach. PLoS One. 2024;19(4):e0299442.

Otelea MR, Nartea R, Popescu FG, Covaleov A, Mitoiu BI, Nica AS. The Pathological Links between Adiposity and the Carpal Tunnel Syndrome. Curr Issues Mol Biol. 2022;44(6):2646-2663.

Fahmi DS, El-Shafey AM. Carpal tunnel syndrome in fibromyalgia patients – A crucial factor for their functional impairment. Egypt Rheumatol 2013;35:175-9.

Neuhaus V, Christoforou D, Cheriyan T, Mudgal CS. Evaluation and treatment of failed carpal tunnel release. Orthop Clin North Am. 2012;43(4):439-47.

Sprangers PN, Westenberg RF, Langer MF, Oflazoglu K, van der Heijden EPA. State of the art review. Complications after carpal tunnel release. J Hand Surg Eur Vol. 2024;49(2):201-214.

Werner BC, Teran VA, Deal DN. Patient-Related Risk Factors for Infection Following Open Carpal Tunnel Release: An Analysis of Over 450,000 Medicare Patients. J Hand Surg Am. 2018;43(3):214-219.

Kumar AA, Lawson-Smith M. Pillar Pain After Minimally Invasive and Standard Open Carpal Tunnel Release: A Systematic Review and Meta-analysis. J Hand Surg Glob Online. 2024;6(2):212-221.

Gmainer DG, Hecker A, Brinskelle P, Draschl A, Reinbacher P, Kamolz LP, Lumenta DB. Persistent Pain as an Early Indicator for Operative Carpal Tunnel Revision after Primary Release: A Retrospective Analysis of Recurrent and Persistent Carpal Tunnel Syndrome. Healthcare (Basel). 2023;11(14):2100.

Cotterell A, Griffin M, Downer MA, Parker JB, Wan D, Longaker MT. Understanding wound healing in obesity. World J Exp Med. 2024;14(1):86898.

Published

2024-10-31

How to Cite

Nanci, G. M., Kempf, O. R., Martins, V. V., Ismael, L. K., Gonçalves, V. A., Souto, C. J. S., & Rezende, L. G. R. A. (2024). Evaluation of Symptoms after Surgical Release of the Carpal Tunnel in Patients Operated on in the last 10 Years in a Tertiary Academic Hospital. ARCHIVES OF HEALTH INVESTIGATION, 13(10), 3076–3082. https://doi.org/10.21270/archi.v13i10.6486

Issue

Section

Original Articles