Ijaz Hussain Wadd, Ain Ullah Khan, Abdullah Haroon, Anjum Habib Vohra.
Neurological Outcome of Carpal Tunnel Decompression in Carpal Tunnel Syndrome.
Pak J Neuro Surg Jan ;18(1):95-101.

Objective: To evaluate the outcome of carpal tunnel decompression in Carpal tunnel syndrome. Study Design: Prospective and retrospective observational study. Materials and Methods: This study was conducted at the Department of Neurosurgery, PGMI / AMC / Lahore General Hospital, Lahore, during the period of 4 years from Jan. 2009 to Jan. 2013. All patients with symptoms and signs of carpal tunnel syndrome and with positive nerve conduction study were included in our study. Exclusion criteria was those unfit for surgery such as patients on warfarin and patient with mild symptoms treated with wrist splint and oral analgesic, diabetic, hypothyroid patient, patients in which nerve conduction study points to radiculopathy and patients with history of trauma with carpal bone fracture were excluded from study. Prospective clinical data collected included patient reported outcome measures and satisfaction scores, touch threshold, pinch and grip strength. Patients were assessed clinically, underwent nerve conduction studies and surgery as indicated. Baseline and one – year follow-up data were analysed for 57 patients (62 hands). Results: A total of 57 patients (62 hands) treated with surgery between Jan 2009 and Jan 2013 agreed to participate in the study. Complete data at baseline and 1 year were available for 57 patients (62 hands). There was significant improvement in all domains of the Boston Carpal Tunnel and Michigan Hand Outcomes questionnaires, grip strength and touch threshold. There were no adverse events. Eight patients (14%) requested advice on scar management or had queries regarding the duration of post-operative recovery of sensation and function. The total mean operating time was 12.8 minutes (range: 5–15 minutes) and the mean tourniquet time was 2.5 minutes (range: 1–11 minutes). Patient satisfaction as judged using a Picker questionnaire was very high. Conclusions: A highly efficient clinical service involving both diagnostics and treatment can be delivered through minimum hospital visit and day care surgery while maintaining optimal outcomes and high patient satisfaction.

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