Carpal Tunnel Syndrome Diagnostic Method and Surgical Wait Times: Do They Relate and Can We Do It Better?

Background: This study investigated the methods used to diagnose carpal tunnel syndrome (CTS) at a regional hospital and determined whether surgical wait times differed between those who had a nerve conduction study (NCS) and those who did not. Methods: This study consists of a retrospective cross-sectional review of patient records over 24 months, recording demographic information, date of initial orthopaedic clinic consult, date of surgery and diagnostic tool utilised by the assessing clinician. Patients were divided into two groups: those who had an NCS and those who did not. These two groups were statistically analysed to compare surgical wait times from the date of initial consult to the date of surgery. Results: The study determined that 117 carpal tunnel release (CTR) procedures were completed, with NCS used to diagnose CTS in 86 of the 117 patients. The remaining 31 patients were diagnosed using either provocative tests or an ultrasound study. The number of days to surgery was significantly higher amongst participants who had an NCS (median 206 days) compared to the non-NCS groups (median 73 days). Conclusions: It is concluded that the use of NCS in the diagnosis of CTS prolongs the surgical wait times of patients requiring surgery. There are some cases where an NCS is required to provide clarity in an unclear clinical picture; however, given that in many cases a reliable diagnosis of CTS can be made without completion of an NCS, the necessity of routinely completing this investigation should be judiciously considered, especially in circumstances where surgical wait times are of importance to patient outcomes. Level of Evidence: Level III (Therapeutic).