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Early mobilization following carpal tunnel release. A prospective randomized study
A C Cook1, R M Szabo, S W Birkholz
1Kaiser Permenente, Davis, Sacramento, California, USA.
Journal of Hand Surgery (Edinburgh, Scotland)
|April 1, 1995
Summary
Wrist splinting after carpal tunnel release surgery delays recovery and increases pain. Early range-of-motion exercises promote faster return to daily activities and work for carpal tunnel syndrome patients.
Area of Science:
- Orthopedics
- Hand Surgery
- Rehabilitation Medicine
Background:
- Idiopathic carpal tunnel syndrome is a common condition requiring surgical intervention.
- Open carpal tunnel release aims to decompress the median nerve.
- Post-operative management, including wrist splinting, is debated.
Purpose of the Study:
- To evaluate the efficacy of wrist splinting versus early range-of-motion exercises after open carpal tunnel release.
- To assess the impact on functional recovery, pain, and complications.
Main Methods:
- Prospective randomized study of 50 patients undergoing idiopathic carpal tunnel syndrome surgery.
- Patients randomized to 2 weeks of splintage or early (post-operative day 1) range-of-motion exercises.
- Evaluations at 2 weeks, 1, 3, and 6 months included functional testing, physical exam, and questionnaires.
Main Results:
- Splinted patients showed significant delays in returning to daily activities and work (light and full duty).
- Recovery of grip and key pinch strength was slower in the splinted group.
- Increased pain and scar tenderness were noted in splinted patients during the first month; complication rates were similar otherwise.
Conclusions:
- Post-operative wrist splinting after open carpal tunnel release is generally detrimental to recovery.
- Early range-of-motion exercises facilitate faster functional return.
- Splinting may be considered for rare complications like tendon bowstringing or nerve entrapment, but a structured physiotherapy program is recommended.