gms | German Medical Science

Objectives/Interrogation: In case of carpal tunnel syndrome, the patients' fear of the operation may lead to long lasting symptoms. Our hypothesis was that the longer the patient waits till the operation, the worse the results will be.

Methods: We performed a retrospective evaluation of our database on carpal tunnel syndrome. The preoperative and postoperative findings were collected prospectively. In the period between 2014 to 2018 467 patients underwent median nerve release for carpal tunnel syndrome in our center. 24 patients were excluded due to missing data. In each case we performed open carpal tunnel release without synovectomy. The grip and pinch strength were measured with a dynamometer. The changes in numbness, night pain and satisfaction were registered. For the evaluation of subjective findings, a visual analogue scale of 1-10 was used. The patients were selected into 5 groups according to the time interval between the first symptoms and the operation. Significance was evaluated using Z-test (p=0,05).

Results and Conclusions: Values of preoperative daytime and nighttime numbness were similar in all 5 groups. In the first group (symptoms for less than 3 months), the daytime numbness was 6,5, the nighttime numbness was 7,67. The night pain was 6,97 points. These values at the end of the first week, were 5,29 for the daytime numbness, and 4,13 for the nighttime numbness. The night pain almost totally disappeared. All the other groups gave similar results, with only two significant difference. The grip strength increased significantly during the first three months in the first group compared to the preoperative values. Opposite to this in the fifth group (symptoms for more than 3 years) the grip strength did not reach the preoperative level after 3 months. The satisfaction of the patients was similar in all groups, but in the first group there was an increasing tendency during checkups, and the fifth group was the most satisfied (9,2) after 1 week and the values showed a decreasing tendency.

Based on our results we can conclude that regardless of the time from the appearance of the first symptoms the subjective complaints decrease with no significant difference after neurolysis. An early operation will result in a continuously improving tendency in the postoperative stage. Patients with longer anamnesis will reach an early improvement of symptoms thus high satisfaction at 1 week postoperatively. However, with time they do not improve their results. This way our hypothesis failed.