Carpal Tunnel Release for Advanced Disease in Patients 70 Years and Older: Does Outcome from the Patient’s Perspective Justify Surgery?

Author(s): Tomaino MM, Weiser RW

Source: J Hand Surg 26B: 481-483, 2001.

Summary:

The authors retrospectively reviewed 13 patients 70 years of age and older with advanced carpal tunnel syndrome who underwent open carpal tunnel release surgery.  Patient satisfaction and symptom resolution were assessed at an average of 27 months postoperatively using the Brigham Carpal Tunnel Syndrome questionnaire.  Eleven of 13 patients reported only minimal residual symptoms and were either satisfied or very satisfied with the procedure and the status of their hand.

Previous studies have shown that carpal tunnel release surgery can improve clinical symptoms and electrophysiological parameters in cases of long-standing nerve impairment (Nolan et al, JHS, 1992; Aulisa et al, JHS, 1989).  However, complete clinical recovery and significant electrophysiological improvement are unlikely.  If the risks of surgery are acceptable, median nerve decompression for advanced carpal tunnel syndrome in the elderly should be considered when non-operative treatment measures fail to provide satisfactory relief.  Although the surgery may not always be beneficial, especially in those individuals with an associated peripheral neuropathy, it rarely makes these individuals worse.

 


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Journal of Hand Surgery