Ultrasonographic parameters comparison for pre- and postoperative carpal tunnel syndrome release: A single-center...

Carpal tunnel syndrome (CTS) is a prevalent condition characterized by median nerve compression, impacting a significant portion of the population worldwide. While neurophysiological testing has been traditionally employed for diagnosis, recent advancements in ultrasonography have shown promise in offering a noninvasive alternative. In this study, we aimed to evaluate the mid-term postoperative statistical changes of the median nerve and flexor retinaculum, share our ultrasonographic measurement methodologies for standardized reporting, and suggest a set of ultrasonographic parameters for postoperative tracking. A prospective cohort of 18 patients with 24 CTS-affected hands underwent comprehensive evaluations including ultrasonography, nerve conduction studies, and functional assessments before and 6 months after surgical intervention. Various ultrasonographic parameters such as cross-sectional area (CSA), bowing of the flexor retinaculum, displacement of median nerve, and flattening ratio were measured at inlet and outlet levels of the carpal tunnel. Additionally, functional outcomes including grip strength, pinch strength, disabilities of the arm, shoulder, and hand score (DASH), visual analog scale (VAS), and World Health Organization Quality of Life score (WHOQOL) were assessed. A total of 18 patients (24 wrists) with CTS were included in this study. In this study, there were 15 females and 3 males, with 12 single-sided surgeries and 6 double-sided surgeries. The mean age was 45 years old with a mean duration of symptoms of 26 months. There were no complications and no reoperations during the follow-up period. Improvements in all postoperative parameters were recorded, with statistically significant improvements noted in CSA at outlet level, bowing of the flexor retinaculum at outlet level, displacement of median nerve at inlet and outlet level, flattening ratio at the outlet level and functional scores. The primary contribution of this study lies not in individual ultrasonographic parameters but in the integration of CSA at the outlet, flexor retinaculum bowing, and median nerve displacement into a unified, clinically feasible assessment framework. This streamlined protocol is rapid, reproducible, and suitable for routine postoperative monitoring, offering greater clinical utility than single-parameter evaluation.