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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2004 April;55(2):51-6
Potential factors in the outcome of surgical repair for carpal tunnel syndrome. Prelimi-nary study of 100 patients
Ceffa R., Désayeux S., Sguazzini P., Mordente G.
S. S. di Chirurgia della Mano S. C. di Ortopedia e Traumatologia Azienda Ospedale Maggiore della Carità, Novara
Aim. With the growing number of interventions for treating carpal tunnel syndrome, which usually provide complete and early relief of symptoms, the number of patients unsatisfied with short-term results has also risen.
Methods. To determine the possible causes of partial failures, 100 patients were evaluated for subjective symptoms, known risk factors, occupational factors; in 50 patients blood chemistry values were measured as well. Post-surgical follow-up at 15 days, 3 months and 1 year was conducted to evaluate resolution of paresthesias and hypoesthesia, restoration of hand function, surgical wound healing and patient satisfaction.
Results. Alterations in blood chemistry were found in most patients and a positive occupational factor in 25%. No correlations were found between delayed healing and severity of preoperating symptoms, presence of occupational factors or alterations in blood chemistry values.
Conclusion. Metabolic-hormonal alterations may contribute to the development of carpal tunnel syndrome and therefore warrant further study; however, they do not appear to play a determinant role in the prognosis of the disease after surgical repair. Treatment failures may be due to differences in technique, which have not been fully evaluated so far. A spontaneous tendency to a long-term improvement of results of surgery was found; hence, follow-up at 1 year is recommended to obtain a more complete evaluation of the quality of the outcomes.