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Does carpal tunnel release provide long-term relief in patients with hemodialysis-associated carpal tunnel syndrome?

Authors
 Ho Jung Kang  ;  Il Hyun Koh  ;  Won Yong Lee  ;  Yun Rak Choi  ;  Soo Bong Hahn 
Citation
 CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, Vol.470(9) : 2561-2565, 2012 
Journal Title
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH
ISSN
 0009-921X 
Issue Date
2012
MeSH
Aged ; Carpal Tunnel Syndrome/diagnosis ; Carpal Tunnel Syndrome/etiology ; Carpal Tunnel Syndrome/physiopathology ; Carpal Tunnel Syndrome/surgery* ; Chi-Square Distribution ; Decompression, Surgical*/adverse effects ; Female ; Humans ; Ligaments/physiopathology ; Ligaments/surgery* ; Male ; Middle Aged ; Orthopedic Procedures*/adverse effects ; Pain/etiology ; Pain/surgery ; Recovery of Function ; Renal Dialysis/adverse effects* ; Republic of Korea ; Retrospective Studies ; Severity of Illness Index ; Surveys and Questionnaires ; Time Factors ; Treatment Outcome
Abstract
BACKGROUND: Carpal tunnel syndrome (CTS) is a common complication in patients receiving long-term hemodialysis. In the short-term however, these patients are less likely to have pain relief and restoration of function after carpal tunnel release. However, it is unclear whether patients who have release for hemodialysis-associated CTS have differing persisting relief of symptoms compared with patients with idiopathic CTS.

QUESTIONS/PURPOSES: We therefore compared (1) the severity of pain and level of function in patients who had release for hemodialysis-associated CTS with scores of patients who had release for idiopathic CTS, and (2) the operation-related complications.

METHODS: We retrospectively reviewed 36 patients with CTS who were receiving hemodialysis and 54 patients with idiopathic CTS. Control subjects were matched for age, gender, and symptom severity. We obtained Boston Carpal Tunnel Questionnaire (BCTQ) scores preoperatively and at each followup. The minimum followup was 24 months (mean, 44.3 months; range, 24-90 months), although all comparisons were made at 2 years.

RESULTS: Two years after carpal tunnel release, the mean BCTQ-symptom (S) /BCTQ-function (F) scores improved from 3.3/2.1 to 2.1/2.1 in the hemodialysis-associated CTS group and from 3.2/2.3 to 1.4/1.4 in the idiopathic CTS group. All but six patients receiving hemodialysis had lower (better) BCTQ-S scores than their initial scores. Four patients had complications, all with hemodialysis-associated CTS: two had revision carpal tunnel releases and two had delayed wound healing. We observed no arteriovenous fistula-related complication.

CONCLUSIONS: Patients with hemodialysis-associated CTS seem to remain impaired, unlike patients with idiopathic CTS, but the majority of them might have much improved CTS-related symptoms at 2 years after carpal tunnel release.
Full Text
http://link.springer.com/article/10.1007%2Fs11999-012-2309-4
DOI
10.1007/s11999-012-2309-4
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Ho Jung(강호정) ORCID logo https://orcid.org/0000-0003-0273-1264
Koh, Il Hyun(고일현) ORCID logo https://orcid.org/0000-0001-9823-8516
Choi, Yun Rak(최윤락)
Hahn, Soo Bong(한수봉)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90038
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