Complications and outcome in open carpal tunnel release. A 6-year follow-up in 92 patients

In this retrospective study, 92 patients (83% attendance rate) were examined 6 years after open carpal tunnel release. A questionnaire was answered by the patient and a physical examination was made by an independent observer. Five complications were found, of which 4 were early postoperative problems and one was a major complication with long-term disability. In one third of the patients numerous complaints were noted even after six years. Recurrences were found in 9 cases. No lacerations of nerves, tendons or vessels were seen and no patient developed reflex sympathetic dystrophy. The overall subjective outcome showed that 91% of the patients were free of symptoms or improved. The grip strength at follow-up was reduced, if the symptoms had been present for more than 12 months, as compared to less than 12 months, (p = 0.009) and when associated, unspecific brachialgia had been present (p = 0.02). No differences were found in conjunction with the operating surgeon being either an orthopaedic resident or a specialist in hand surgery. In conclusion, open carpal tunnel release had a subjectively favourable outcome, but due to complications and postoperative complaints, further investigations into alternative techniques seem necessary.