[Chronic polyarthritis and carpal tunnel syndrome. Results of follow-up]

Between July 1974 and December 1989, carpal tunnel-syndromes (CTS) were operated on in 903 hands of 746 patients. 147 of these patients (191 hands) were suffering from chronic inflammatory joint diseases. In 11 patients CTS was the first sign of rheumatoid arthritis (R.A.). The hands showed intraoperatively in 44.8% (n = 86/191) an extensive tenosynovitis with an aggressive infiltration. In 19% (n = 36/191), we had to extend the obligate tenosynovectomy on the flexor tendon parts of the fingers and ligaments (28 hands). 21 articulosynovectomies on the wrist or finger joints were performed. In 6 hands (8.0%) tendon ruptures were repaired. A questionnaire was completed for 107 of 147 patients (72.8%) (with 145 operated hands). Clinical (77 hands) and electromyographical examinations (49 hands) were performed an average of 5.1 (0.7-15) years postoperatively. 20 patients (13.6%) died, 20 could not be traced. In 86% (n = 125/145) of the patients we achieved relief of pain and a marked reduction of neurological deficits. 96.3% of the patients were content. The improvement of function of the hand after surgical intervention is of a great benefit for the patient with R. A. The overall risks of the procedure are low (complications 14%; no recidivism). Therefore, we recommend surgery in early stages after a confirmed diagnosis or a reasonable suspicion.