Original ArticleNo Access

The Impact of Carpal Tunnel Release on Two-Point Discrimination, Quick Disabilities of Arm, Shoulder and Hand Score and Distal Motor Latency – A Multi-centre Prospective Study

Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Bibai, Japan

Correspondence to: Yukinobu Kamiya, Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Higashi-4-Jo Minami-1-Chome, Bibai, Hokkaido 072-0015, Japan. Tel: +81-126-63-2151, Fax: +81-126-63-2853.

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Akio MINAMI

Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Bibai, Japan

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Yasuaki TOJO

Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Bibai, Japan

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Yoji MIKAMI

Department of Orthopaedic Surgery, Yokohama Rosai Hospital, Yokohama, Japan

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Norimasa IWASAKI

Department of Orthopaedic Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan

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, and

Akinori SAKAI

Department of Orthopaedic Surgery, University of Occupational and Environmental Health, Kitakyusyu, Japan

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https://doi.org/10.1142/S2424835522500941Cited by:0 (Source: Crossref)

Abstract

Background: The authors conducted a prospective, multi-centre study to assess the impact of carpal tunnel release (CTR) on Two-Point Discrimination (2-PD), Quick Disabilities of Arm, Shoulder and Hand Score (Q-DASH), and Distal Motor Latency (DL). The primary aim was to determine the change in outcome measurements (2-PD, Q-DASH and DL) preoperatively and postoperatively at 6 months and 1 year. The secondary aims of the study were to determine whether the postoperative outcomes were different at the 6-month and 1-year follow-up and if there was difference in outcomes based on the preoperative severity of carpal tunnel syndrome (CTS).

Methods: A total of 205 hands in 171 patients underwent CTR at five hospitals over a 2-year period. A total of 110 hands in 94 patients were followed-up and analysed. The 2-PD, Q-DASH and DL were measured for all patients preoperatively and at 6 months and 1 year postoperatively. Patients were divided into two groups ‘mild’ and ‘severe’ based on pre-operative DL score (mild ≤ 8.1 msec). The change in preoperative and postoperative 2-PD, Q-DASH and DL values were compared. The change in pre-operative and post-operative 2-PD and Q-DASH values were also compared between the ‘mild’ and ‘severe’ groups.

Results: The 2-PD, Q-DASH and DL showed significant improvement at 6-month and 1-year follow-ups compared to pre-operative values. However, there were no significant differences in all three parameters between the 6-month and 1-year measurements. There was significant improvement in preoperative and postoperative 2-PD and Q-DASH scores between the mild and severe groups.

Conclusions: CTR is an effective treatment for patients with CTS with significant improvement in all three outcome parameters (2-PD, Q-DASH and DL). The improvement in outcome plateaus at 6 months and additional follow-up may not be useful.

Level of Evidence: Level II (Therapeutic)

Keywords:

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