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Metacarpal Small Incision for Carpal Tunnel Syndrome
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Consecutive versus simultaneous bilateral carpal tunnel release.

Robert A Weber1, Kara M Boyer

  • 1Department of Surgery, Division of Plastic Surgery, Scott and White Memorial Hospital, Scott, Sherwood and Brindley Foundation, 2401 South 31st Street, Temple, TX, USA. rweber@swmail.sw.org

Annals of Plastic Surgery
|December 23, 2004
PubMed
Summary
This summary is machine-generated.

Simultaneous bilateral carpal tunnel release is cost-effective and safe. Patients experience similar disability and high satisfaction rates compared to staged procedures, making it a recommended approach for bilateral carpal tunnel syndrome.

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Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Surgical Outcomes Research

Background:

  • Bilateral carpal tunnel syndrome often necessitates surgical intervention for both hands.
  • Surgeons frequently opt for staged, one-hand-at-a-time procedures due to concerns about increased post-operative morbidity and disability.

Purpose of the Study:

  • To compare the costs and morbidities associated with simultaneous versus consecutive bilateral carpal tunnel release.
  • To evaluate patient satisfaction and outcomes for both surgical approaches.

Main Methods:

  • Retrospective chart review of 108 patients undergoing bilateral carpal tunnel release.
  • Analysis of clinical visits, operating room time, and time off work.
  • Telephone interviews with 62 patients to assess surgical outcomes and satisfaction.

Main Results:

  • Simultaneous release significantly reduced clinic visits (2 vs. 4.5) and operating room time (48.5 vs. 72.5 minutes) compared to consecutive release (P < 0.0001).
  • Time off work was shorter for simultaneous release (3.25 vs. 6 weeks, P = 0.08).
  • Patient satisfaction was high in both groups (94% for simultaneous, 100% for consecutive), with a strong willingness to repeat the simultaneous procedure (75%).

Conclusions:

  • Simultaneous bilateral carpal tunnel release is considerably less costly than consecutive release.
  • The disability and morbidity associated with simultaneous release are comparable to, not greater than, consecutive release.
  • Simultaneous bilateral carpal tunnel release is recommended for patients with bilateral carpal tunnel syndrome.