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Metacarpal Small Incision for Carpal Tunnel Syndrome
04:08

Metacarpal Small Incision for Carpal Tunnel Syndrome

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The Relationship Between Duration of Dialysis and Carpal Tunnel Release Outcomes: A Systematic Review

Kasra Rahmati1,2, Pavithra Sundaravaradan1,2, Mathangi Sridharan2

  • 1David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA.

Journal of Hand Surgery Global Online
|June 8, 2026
PubMed

Insights

Carpal tunnel release (CTR) helps hemodialysis (HD) patients with carpal tunnel syndrome (CTS). However, long-term HD patients experience less symptom relief and more complications after CTR.

Area of Science:

  • Nephrology
  • Neurology
  • Surgical Outcomes

Background:

  • Carpal tunnel syndrome (CTS) is a common neuropathy, often exacerbated in patients undergoing long-term hemodialysis (HD).
  • Carpal tunnel release (CTR) is the standard surgical treatment, but outcomes can be poorer in long-term HD patients.

Purpose of the Study:

  • To systematically review the relationship between carpal tunnel release (CTR) and outcomes in patients undergoing hemodialysis (HD).
  • To evaluate how the duration of HD therapy impacts the effectiveness of CTR for CTS.

Main Methods:

  • Systematic review of 4 studies involving 199 hemodialysis patients (271 hands) with a minimum 1-year follow-up.
  • Data collected included duration of HD, duration of CTS symptoms, and pre-surgical HD duration.
  • Exclusion criteria: peritoneal dialysis, non-HD associated CTS, and case series with fewer than 10 patients.

Main Results:

  • Overall, CTR improved CTS symptoms in HD patients.
  • 11.4% of hands experienced post-CTR complications, with persistent CTS in 9.2%.
  • Patients on HD for >10 years showed significantly less symptom relief and higher rates of persistent CTS and revision surgery compared to those on HD for <10 years.

Conclusions:

  • Carpal tunnel release offers symptomatic improvement for hemodialysis patients with CTS.
  • Longer duration of hemodialysis is inversely related to symptom improvement after CTR.
  • Timely diagnosis and intervention for CTS in HD patients, considering HD duration, are crucial for optimizing surgical outcomes.
Abstract

Keywords:
Carpal tunnel releaseCarpal tunnel syndromeHemodialysis

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