Factors associated with poor outcome following primary carpal tunnel release in non-diabetic patients

A retrospective study was performed of 112 non-diabetic patients (133 hands) who had open surgical treatment for carpal tunnel syndrome, to determine the factors associated with poor outcome. None of the patients had a previous carpal tunnel release and all had a positive nerve conduction study to confirm the clinical diagnosis of carpal tunnel syndrome. Outcome was assessed at least 18 months after surgery and classified as excellent, good or poor. Outcome was deemed poor when symptoms were minimally improved, unchanged or worse after surgery. This occurred in 13.5% of treated hands. There was a higher chance of poor outcome in patients with physically strenuous work activities. All these heavy or repetitive manual workers were also involved in compensation and their poor outcome correlated with their inability to return to their original work. Other predisposing factors, associated hand conditions, duration of symptoms prior to surgery, the presence of bilateral or nocturnal symptoms, and the severity of the pre-operative nerve conduction deficit did not affect the final outcome after surgery.