gms | German Medical Science

Objectives/Interrogation: To compare postoperative carpal pain of incision directly above the flexor retinaculum with that of incision avoiding directly above (=distal) in patients with carpal tunnel syndrome and to prove that there is no difference concerning duration and cite of postoperative carpal pain between the two incisions.

Methods: The number of enrolled hand were 170 (220 hands were recruited, follow up rate 77%), 70 males and 100 females. The mean age was 73 years (24 to 95). In all cases, surgery was performed by the same surgeon. An original post-operation assessment sheet was developed and every four weeks after surgery, it was used to measure carpal pain by four hand therapists randomly. Patients who could attend follow up consultations, until tenderness had been lost, were enrolled into the study. Time when spontaneous pain has disappeared, time when tenderness has disappeared and location of tenderness were assessed. In all surgery, there was no attempt to identify or preserve the palmar cutaneous nerves.

Results and Conclusions: There were no significant differences between the two incisions in respect of time when spontaneous pain has disappeared (95% confidence interval [-0.8week, 0.8week], P=0.93) and tenderness has disappeared (95% confidence interval [-2.7week, 3.0week], P=0.80). The distribution pattern and ratio of tenderness location were very similar between the two incisions (Figure 1 [Fig. 1], Figure 2 [Fig. 2]).

In open carpal tunnel release surgery, difference of incision site and preserving palmar cutaneous nerves are not factors that have influences on duration and location of carpal pain after surgery. It is supposed that division of the flexor retinaculum itself is a cause of carpal pain after carpal tunnel release.