gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Recurrent and persistent carpal tunnel syndrome: predicting clinical outcome of revision surgery

Meeting Abstract

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  • presenting/speaker Pepijn Sun - Radboudumc, Nijmegen, Netherlands
  • Ruud Selles - Erasmus Medical Center, Rotterdam, Netherlands
  • Miguel Jansen - Erasmus Medical Center, Rotterdam, Netherlands
  • Harm Slijper - Xpert Clinic, Hilversum, Netherlands
  • Dietmar Ulrich - Radboudumc, Nijmegen, Netherlands
  • Erik Walbeehm - Radboudumc, Nijmegen, Netherlands

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-491

doi: 10.3205/19ifssh0647, urn:nbn:de:0183-19ifssh06472

Veröffentlicht: 6. Februar 2020

© 2020 Sun et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objectives/Interrogation: The aim of this study was to evaluate the outcome of revision surgery in patients with recurrent and persistent carpal tunnel syndrome(CTS) and to identify predictors of clinical outcome of revision surgery.

Methods: A total of 114 hands in 112 patients were surgically treated for recurrent and persistent CTS in 1 of 16 specialized hand clinics. As part of routine care, patients were asked to complete online questionnaires regarding demographic data, comorbidities and clinical severity measures. Symptom severity scale (SSS) and function status scale (FSS) were measured with the Boston Carpal Tunnel Questionnaire (BCTQ) at intake and at 6 months postoperatively to evaluate the clinical outcome. Using multivariable regression models, we indentified factors predictive of the outcome as measured by the BCTQ FSS, SSS and total score at 6 months.

Results: Revision surgery significantly improved symptoms and function. Longer total duration of symptoms, a higher BCTQ total score at intake and co-diagnosis of Complex Regional Pain Syndrome (CRPS) were associated with worse outcome after revision surgery at 6 months postoperatively. Respectively 33%, 23% and 30% of the variance in outcome measured by FSS, SSS and BCTO total score could be explained by our multivariable regression models. Although patients with higher BCTQ score at intake have worse outcome, they generally have most improvement of symptoms and function.

Conclusions: This study identified total duration of symptoms, BCTQ total score at intake and co-diagnosis of CPRS as predictors of clinical outcome and confirmed that revision surgery significantly improves symptoms and function in patients with recurrent and persistent CTS. Patients with more severe CTS symptoms have greater improvement in symptoms at 6 months postoperatively as compared to patients with less severe CTS, but 80% of our patients still had residual symptoms 6 months postoperatively. These results can be used to inform both patient and surgeon to manage expectations on improvement of symptoms.