Patient-reported outcomes and functional recovery after carpal tunnel surgery in a developing health care system: insights from clinical practice

Carpal tunnel syndrome (CTS) presents with pain, numbness, and occasional weak hand grip. Diagnosis is predominantly clinical, with initial management involving conservative measures; surgery is considered for non-responsive cases. The Boston Carpal Tunnel Questionnaire (BCTQ), an efficient patient-reported outcome measure, is increasingly utilized for objective treatment assessment. Our study aimed to apply the BCTQ in patients who underwent carpal tunnel release surgery, contributing to the growing use of this effective assessment tool, and utilizing it in assessing patient-reported outcomes after carpal tunnel release surgery in Jordanian population. A retrospective cohort study design was utilized, enrolling 681 patients who underwent carpal tunnel release surgery. Inclusion criteria encompassed patients undergoing open primary carpal tunnel release surgery within a 5-year period (2018-2022), excluding cases of revision surgery, endoscopic surgery, surgery site trauma or fracture, peripheral neuropathies, and those with lost follow-up. In our study (n = 681), patients had a mean age of 52.0 years. Females comprised 77.2%. Diabetes and hypertension were prevalent, with 67.8% and 38.5% of patients, respectively. The mean self-reported functional disability score was 7.2. On BCTQ analysis, females exhibited a significantly higher mean S score compared to males (3.27 vs. 2.9, p = 0.002). We found significantly higher S score differences in patients reporting pain (-1.78 vs. -1.02, p < 0.001), paresthesia (-1.77 vs. -0.77, p < 0.001), nocturnal symptoms (-1.83 vs. -1.05, p < 0.001. Similarly, F score differences were statistically significant for pain (-1.32 vs. -0.080, p < 0.001), and nocturnal symptoms (-1.33 vs. -0.97, p = 0.003). In our cohort, females showed greater symptomatic and functional improvements than males. Smoking and comorbidities had no clear impact on BCTQ scores. Patients with night symptoms, paresthesia, disabling pain, and subjective weak grip displayed significant BCTQ score improvements.