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Persistent Pain as an Early Indicator for Operative Carpal Tunnel Revision after Primary Release: A Retrospective Analysis of Recurrent and Persistent Carpal Tunnel Syndrome.
- Source :
- Healthcare (2227-9032); Jul2023, Vol. 11 Issue 14, p2100, 10p
- Publication Year :
- 2023
-
Abstract
- Background: Prolonged symptoms of carpal tunnel syndrome (CTS) after primary carpal tunnel release (CTR) can reduce the quality of life and lead to multiple referrals across specialties. The following study aimed to identify differences in symptoms, signs, and intraoperative findings between recurrent and persistent CTS cases to avoid undesired outcomes after primary CTR. Methods: A retrospective analysis was conducted on revision CTRs performed between 2005 and 2015 using literature-based definitions for recurrent (a relapse of symptoms occurs following a symptom-free period of ≥3 months) and persistent (symptoms persisting longer than three months after surgical release) CTS. The parameters assessed were symptoms, clinical signs, and intraoperative findings. Results: Out of 53 cases, 85% (n = 45) were external referrals, whereby our own revision rate was 0.67% (n = 8/1199). Paresthesia and numbness were frequent in both groups; however, abnormal postoperative pain was reported more often in persistent cases (86%; n = 30/35) in comparison to recurrent cases (50%; n = 9/18; p = 0.009). Scarring around the median nerve was observed in almost all recurrent cases (94%; n = 17/18) and in 40% (n = 14/35) of persistent cases (p < 0.001). Incomplete division of the palmar ligament was the primary cause for revision in the persistent cohort (49%; n = 17/35). Conclusions: For patients experiencing symptoms for more than three months after CTR, primarily presenting as pain, it is advisable to consider referring the patient to a certified hand clinic for additional evaluation. [ABSTRACT FROM AUTHOR]
- Subjects :
- SURGICAL therapeutics
CHRONIC pain
EVALUATION of medical care
NONPARAMETRIC statistics
CARPAL tunnel syndrome
RETROSPECTIVE studies
PARESTHESIA
MANN Whitney U Test
FISHER exact test
DISEASE relapse
STATISTICAL hypothesis testing
DESCRIPTIVE statistics
DATA analysis software
LONGITUDINAL method
SYMPTOMS
Subjects
Details
- Language :
- English
- ISSN :
- 22279032
- Volume :
- 11
- Issue :
- 14
- Database :
- Complementary Index
- Journal :
- Healthcare (2227-9032)
- Publication Type :
- Academic Journal
- Accession number :
- 169331963
- Full Text :
- https://doi.org/10.3390/healthcare11142100