The Effect of Age and Gender upon Symptoms and Surgical Outcomes in Carpal Tunnel Syndrome

2005 ◽  
Vol 30 (6) ◽  
pp. 599-604 ◽  
Author(s):  
J. L. HOBBY ◽  
R. VENKATESH ◽  
P. MOTKUR
Keyword(s):  
Patient Satisfaction ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Surgical Outcome ◽  
Carpal Tunnel Release ◽  
Hand Function ◽  
Age And Gender ◽  
Younger Patients ◽  
Tunnel Syndrome ◽  
And Gender

There is conflicting evidence regarding the effectiveness of carpal tunnel release in older patients. This is a prospective study which evaluates the impact of age and gender upon symptoms, self-reported disability and surgical outcome in a series of 97 patients with carpal tunnel syndrome. Symptom severity, hand function and patient satisfaction were assessed using the Boston Carpal Tunnel Questionnaire and the Patient Evaluation Measure. A statistical correlation of age and gender with symptoms, hand function and surgical outcome was performed with questionnaires administered before open carpal tunnel decompression and 6 months after surgery. Women reported greater pre-operative symptoms and disability than men, but there was no gender-related difference in surgical outcome or patient satisfaction. There was no difference in surgical outcome between patients 60 and 70 years of age and younger patients. The majority of patients over the age of 70 reported an improvement in symptoms and function, but they were less satisfied with their treatment than younger patients. Some patients had problems with persistent numbness and loss of dexterity following surgery. The outcome of carpal tunnel release in terms of improvement in the symptom and functional scores is sufficient to justify surgery in the elderly, but surgical outcomes are less predictable than in younger patients and we recommend that this is explained to them when obtaining consent for surgery.

Clinical Update: Assessing Maximum Medical Improvement in Carpal Tunnel Syndrome

2003 ◽  
Vol 8 (4) ◽  
pp. 4-5
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Proper Time ◽  
Carpal Tunnel Release ◽  
Hand Function ◽  
Factors Affecting ◽  
Early Results ◽  
Medical Evaluation ◽  
Nerve Recovery ◽  
Tunnel Syndrome

Abstract Permanent impairment cannot be assessed until the patient is at maximum medical improvement (MMI), but the proper time to test following carpal tunnel release often is not clear. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) states: “Factors affecting nerve recovery in compression lesions include nerve fiber pathology, level of injury, duration of injury, and status of end organs,” but age is not prognostic. The AMA Guides clarifies: “High axonotmesis lesions may take 1 to 2 years for maximum recovery, whereas even lesions at the wrist may take 6 to 9 months for maximal recovery of nerve function.” The authors review 3 studies that followed patients’ long-term recovery of hand function after open carpal tunnel release surgery and found that estimates of MMI ranged from 25 weeks to 24 months (for “significant improvement”) to 18 to 24 months. The authors suggest that if the early results of surgery suggest a patient's improvement in the activities of daily living (ADL) and an examination shows few or no symptoms, the result can be assessed early. If major symptoms and ADL problems persist, the examiner should wait at least 6 to 12 months, until symptoms appear to stop improving. A patient with carpal tunnel syndrome who declines a release can be rated for impairment, and, as appropriate, the physician may wish to make a written note of this in the medical evaluation report.

scholarly journals Ultrasonography Findings in Severe Carpal Tunnel Syndrome

Hand ◽  
2018 ◽  
Vol 15 (1) ◽  
pp. 64-68
Author(s):  
Gideon Nkrumah ◽  
Alan R. Blackburn ◽  
Robert J. Goitz ◽  
John R. Fowler
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Nerve Conduction Studies ◽  
Cross Sectional ◽  
Younger Patients ◽  
Tunnel Syndrome ◽  
Sensory Latency ◽  
Pisiform Bone

Background: Increasing severity of carpal tunnel syndrome (CTS), as graded by nerve conduction studies (NCS), has been demonstrated to predict the speed and completeness of recovery after carpal tunnel release (CTR). The purpose of this study is to compare the cross-sectional area (CSA) of the median nerve in patients with severe and nonsevere CTS as defined by NCS. Methods: Ultrasound CSA measurements were taken at the carpal tunnel inlet at the level of the pisiform bone by a hand fellowship–trained orthopedic surgeon. Severe CTS on NCS was defined as no response for the distal motor latency (DML) and/or distal sensory latency (DSL). Results: A total of 274 wrists were enrolled in the study. The median age was 51 years (range: 18-90 years), and 72.6% of wrists were from female patients. CSA of median nerve and age were comparatively the best predictors of severity using a linear regression model and receiver operator curves. Using cutoff of 12 mm2 for severe CTS, the sensitivity and specificity are 37.5% and 81.9%, respectively. Conclusions: Ultrasound can be used to grade severity in younger patients (<65 years) with a CTS-6 score of >12.

Validity and Responsiveness of the Patient Evaluation Measure as an Outcome Measure for Carpal Tunnel Syndrome

2005 ◽  
Vol 30 (4) ◽  
pp. 350-354 ◽  
Author(s):  
J. L. HOBBY ◽  
C. WATTS ◽  
D. ELLIOT
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Outcome Measure ◽  
Carpal Tunnel Release ◽  
Hand Function ◽  
Objective Measures ◽  
Dash Score ◽  
Patient Evaluation ◽  
Tunnel Syndrome ◽  
Evaluation Measure

The aim of this study was to assess the validity of the Patient Evaluation Measure questionnaire (PEM) as an outcome measure in carpal tunnel syndrome. The PEM was compared to the DASH questionnaire and to objective measurements of hand function. We also compared its responsiveness to changes following carpal tunnel release with that of the DASH score. Twenty-four patients completed the PEM and DASH questionnaires before and 3 months after open carpal tunnel release. Grip strength, static two-point discrimination and the nine-hole peg test were measured. There was a significant correlation between individual items of the PEM and the objective measures. There was also strong correlation between PEM and DASH scores. The PEM showed a greater responsiveness to change (effect size 0.97) than the DASH score (effect size 0.49). The PEM correlates well with objective measures of hand function and the DASH score when used in carpal tunnel syndrome. It is more responsive to change than the DASH score. It is very simple to complete and score and is an appropriate and practical outcome measure in carpal tunnel syndrome.

scholarly journals Surgical Outcome of Open Carpal Tunnel Release Using Global Symptom Severity Score

2020 ◽  
Vol 24 (3) ◽  
Author(s):  
MUHAMMAD NAWAZ KHAN ◽  
RIAZ-UR- REHMAN ◽  
RIZWAN ULLAH KHATTAK ◽  
ATTIYA NASIR SIDDIQUE ◽  
M. ALI NOMAN
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Severity Score ◽  
Surgical Outcome ◽  
Carpal Tunnel Release ◽  
Dominant Hand ◽  
Symptom Severity Score ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release

Objective:  Purpose of conducting this study was to evaluate the surgical outcome of open carpal tunnel release using Global Symptom Severity score (GSS) in our local setting. Material and Methods:  This prospective analytical study was conducted in the Neurosurgery Department Hayatabad Medical Complex, Peshawar. We operated consecutive 105 Carpal tunnel syndrome cases over a period of 2 years via open carpal tunnel release (OCTR) method. All of these cases were surgically indicated. All patients were evaluated preoperatively with clinical assessment and NCS. Cases were operated under local anesthesia as a day case surgery. Patients were evaluated at 3 months follow-up visit using global symptom severity score (GSS) and compared with pre operative GSS. The paired sample test was applied to obtain p value. Results:  Total 105 patients were operated during study period. 72 (69%) patients were women and 33 (31%) were men. The mean age of patients was 41 years. 70 (66.66%) procedures were done for the right hand and 35 (33.33%) were performed for left hand. Pre-op Mean GSS score was 27 ± 2.5 which decreased to 2.1 ± 0.43 postoperatively (P < 0.005). Conclusion:  Carpal tunnel syndrome is more commonly affecting the dominant hand of middle aged females. Open carpal tunnel release procedure is the safe and effective treatment for this compressive neuropathy.

Carpal Tunnel Syndrome and Hand Function

1993 ◽  
Vol 1 (1) ◽  
pp. 44-46
Author(s):  
G Allan Taylor
Keyword(s):  
Informed Consent ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Hand Function ◽  
Pinch Strength ◽  
High Incidence ◽  
Tunnel Syndrome ◽  
Loss Of Strength ◽  
Age And Sex

GA Taylor. Carpal tunnel syndrome and hand function. Can J Plast Surg 1993; 1 (1):44-46. A prospective review of 78 hands in 58 patients with carpal tunnel syndrome is presented. The author's technique for carpal tunnel release under local anesthesia is described. Comparison of the patients in the series with age- and sex-matched controls revealed a high incidence of preoperative weakness of grip and pinch strength. Postoperatively, many patients experienced further loss of strength persisting six months or more. Some had not regained preoperative strength by six months. Explanations for diminished hand strength in patients with carpal tunnel syndrome both pre- and postoperatively are advanced and recommendations made for improved informed consent for patients undergoing carpal tunnel release.

scholarly journals Author Correction: Associations between hand function and electrophysiological measurements in hand osteoarthritis patients of different ages with or without carpal tunnel syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Young Hoon Kim ◽  
Eun Young Han ◽  
Jinseok Kim ◽  
Kyu‑Bum Seo ◽  
Young Tae Jeon ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Hand Function ◽  
Hand Osteoarthritis ◽  
Different Ages ◽  
Electrophysiological Measurements ◽  
Tunnel Syndrome

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

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