Manzoor Rashid, Muhammad Saqib.
Surgical Management of severe Carpal Tunnel Syndrome. What`s the Long-Term Outcome.
Ophthalmol Update Jan ;15(4):424-7.

Background: Carpal tunnel syndrome is a common peripheral nerve compressive neuropathic disorder and severe symptoms are managed by surgical decompression. However, long-term outcome data is limited. Objectives: To study the long-term outcome of surgical decompression in severe carpal tunnel syndrome in terms of improvement in nocturnal pain and numbness. Methods: This is a prospective quasi-experimental study of 18-month duration conducted at Bacha Khan Medical Complex, Swabi. 30 patients who were operated for severe carpal tunnel syndrome were included in the study and were followed for an average of 18 months (range: 6 - 24 months). Data was collected about preoperative and postoperative pain scores in terms of visual analogue scale (VAS). A patient satisfaction survey using a five-item Likert scale was conducted at the end of 6-months. Outcome was categorised according to pain scores and satisfaction. Results: All werefemale patients with mean age of 42.5 � 8.1 years. The mean preoperative VAS was 6.9 � 0.9 and mean postoperative VAS was 2.1 � 1.4. The median satisfaction score was 4 (satisfied) with a range: 1 - 5. Overall 23 (76.7%) patients had favourable outcome while 7 (23.3%) patients had unfavourable outcome. Patients who had symptoms for longer than 12 months were more likely to have an unfavourable outcome as compared to those who had less 12 months of symptoms (p < 0.0001). Conclusion: Severe carpal tunnel syndrome responds quickly to the open release technique and patient satisfaction is higher. However, longer symptoms duration is a factor which can result in unfavourable outcome in terms of pain relief and relief from numbness.

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