Carpal tunnel syndrome in elderly patients: results of surgical decompression

This study prospectively compared preoperative and postoperative (6 months after surgical release) clinical and electrophysiological evaluation and self-administered Boston questionnaire (BQ) findings of a series of elderly carpal tunnel syndrome (CTS) patients with those of young and adult patients. Three hundred twenty three consecutive hands (282 patients) underwent surgery between 1997 and 2000. Patients were divided into four age groups: group 1 (20-40 years), 49 hands; group 2 (41-54 years), 96 hands; group 3 (55-69 years), 106 hands; and group 4 (70-90 years), 72 hands. Sex ratio, education, duration and bilaterality of CTS, history of wrist and hand trauma, connective tissue and thyroid diseases, diabetes, polyneuropathy, renal failure, and other nerve entrapment syndromes were recorded. The elderly group (group 4) only had more cases of diabetes than groups 1 and 2 (young and adult patients). Before surgery, elderly patients showed more severe clinical objective and electrophysiological findings than young and adult patients. Preoperative subjective findings (BQ scores) were similar in all four groups. Although their absolute postoperative BQ scores and clinical objective and electrophysiological stages improved, elderly patients showed less improvement in all findings than the 20-54 age groups, presumably due to greater preoperative damage and less repair capacity of the compressed nerve. This, however, is not a contraindication for surgical release in elderly patients.