Prognostic indicators of postoperative objective improvement in carpal tunnel syndrome: A retrospective study

Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy affecting the upper limb, with surgical intervention as the primary treatment. This study aims to identify predictive factors influencing postoperative motor and sensory recovery following carpal tunnel release (CTR).

A retrospective analysis was conducted on 95 patients (117 hands), with objective outcomes measured by tip pinch strength and two-point discrimination (2PD) six months postoperatively. Motor recovery was defined as the recovery rate of tip pinch strength ≥ 1.2, while sensory recovery was defined as 2PD < 6 mm. Predictive factors such as age, gender, body mass index, comorbidities, and preoperative physical strength were analyzed using univariate and multivariate logistic regression.

Our study showed that younger patients (<73 years) and those patients with better preoperative sensory function had better significant postoperative sensory recovery (age: OR 5.5p = 0.003, 2PD: OR 3.3p = 0.042). Preoperative pinch strength was a significant predictor of motor recovery, while the presence of diabetes mellitus was associated with poorer sensory recovery. Although subjective measures such as the Quick DASH and visual analog scale improved postoperatively, they did not correlate with objective motor and sensory recovery.

These findings suggested the importance of preoperative differences in pinch strength, sensory function and age in predicting postoperative prognosis in patients with CTS. Understanding these prognostic factors may help clinicians to provide patients with different measures of subjective improvement and to manage their expectations.