Delayed improvement after endoscopic carpal tunnel release.

Area of Science:

• Orthopedics
• Neurosurgery
• Surgical Innovation

Background:

• Carpal tunnel syndrome (CTS) is a common condition causing hand pain and paresthesia.
• Endoscopic carpal tunnel release (ECTR) is a widely used surgical treatment for CTS.
• While most patients experience rapid relief, some exhibit delayed symptom improvement post-ECTR.

Purpose of the Study:

• To investigate the characteristics of carpal tunnel syndrome patients with delayed improvement after ECTR.
• To identify potential predictive factors for delayed symptom resolution following endoscopic carpal tunnel release.

Main Methods:

• A retrospective analysis of 1194 hands undergoing single-portal ECTR from 2002 to 2011.
• Inclusion of 570 hands with at least 1-year follow-up, divided into early (Group A) and delayed (Group B) improvement groups based on a 1-month criterion.
• Comparison of demographic data, clinical severity, and electrodiagnostic findings between the two groups.

Main Results:

• Of 545 satisfied patients, 510 (Group A) improved within 1 month, while 35 (Group B) showed delayed improvement (2-6 months).
• Clinical severity (Grade II and III) and electrodiagnostic severity (moderate and severe) showed a tendency towards delayed improvement, though statistical significance was not reached.
• Group B comprised 35 hands, with improvement occurring at 2, 3, or 6 months post-ECTR.

Conclusions:

• Predicting delayed symptom response after ECTR in carpal tunnel syndrome patients remains challenging.
• A postoperative observation period of at least six months is recommended for patients not experiencing immediate symptomatic relief.
• Further research may be needed to elucidate specific biomarkers or factors influencing delayed recovery in a subpopulation of CTS patients.