gms | German Medical Science

Objectives/Interrogation: To explore when and how patients return to different types of work after carpal tunnel release (CTR) and to identify the key factors predicting the duration of post-operative sick leave.

Methods: Participants with CTS (carpal tunnel syndrome) were recruited pre-operatively from 16 UK sites. Eligibility criteria included: working in paid employment for more than 20 hours per week and no history of CTR. Demographic, clinical, functional and occupational details were collected at baseline. After CTR, participants were followed-up weekly until return to work with a symptom diary, and by self-reported questionnaire at 4 and 12 weeks. Operative details were extracted from the medical records.

Results: A total of 222 individuals were recruited (61% female). Mean age was 51 years (SD 9.9) and mean body mass index was 29.6 (SD 6.1). Most participants had experienced CTS symptoms for more than a year and 40% were expecting bilateral CTR via staged procedures. Fewer than half of participants were diagnosed with classic CTS according to Katz hand diagrams. Mean Atroshi CTS-6 scores were 3.3 (SD 0.9) for the right and 3.4 (SD 1.0) for the left.

Nineteen percent of participants were self-employed, 77% were employed with a permanent contract and seven individuals had a temporary or zero hours contract. Forty-four percent of participants worked in manual occupations using the National Statistics Socio-Economic Classification. Median expected work absence after CTR was 14 days (IQR 14-28 days); 17.5 days for manual workers (IQR 14-28 days) and 14 days for non-manual workers (IQR 10-28 days).

Study follow-up will be completed in January 2019. The return to work processes and timescales will be summarised descriptively and a Cox Proportional-Hazards analysis will be used to determine the key factors influencing return to work time among this cohort.

Conclusions: There is a lack of evidence-based information advising when patients might expect to be able to return to different occupational duties after CTR and these findings will help shape future guidance. We have recruited a cohort of patients undergoing CTR and will describe the reported time taken to return to different types of work. Analysis of the determinants of return to work time may identify potential targets for the development of interventions to improve return to work outcomes after CTR.