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CTS surgery equally improves motor and sensory function in patients with diabetes
Improvement was rapid for many factors Swedish researchers tracked in two groups through 1 year.
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Carpal tunnel surgical intervention benefitted patients who have diabetes mellitus as much as it did nondiabetic control patients based on results of a prospective study conducted in Sweden.
Results for all outcomes analyzed were similar across the groups, according to Niels O.B. Thomsen, MD. However, the intolerance to cold that nearly 60% of all patients experienced preoperatively did not improve equally. “The improvement was much more pronounced in the control patients,” he said.
Both groups demonstrated rapid yet equal sensory recovery through the 1-year follow-up, and although their abductor pollicis brevis (APB) strength also improved, it did so much more gradually, Thomsen noted in a presentation at the American Society for Surgery of the Hand 63rd Annual Meeting in Chicago.
Single-surgeon series
Investigators from Malmö, Sweden, prospectively studied 35 patients with carpal tunnel syndrome (CTS) and diabetes. Their median age was 54 years and they had diabetes for a median 15 years, ranging from 1 to 43 years. The study group was matched for age and gender to 31 patients with a median age of 51 years who had idiopathic CTS and no signs of diabetes.
All patients had CTS symptoms at least 1 year, but the control group’s duration of symptoms was slightly longer: 36 months vs. 24 months in the study group.
One surgeon operated on both groups, treating just their CTS and no concomitant conditions. and one occupational therapist performed the baseline, 6-month, 12-month and 1-year physical exams.
Symptom resolution
In addition to studying such variables such as APB strength and cold tolerance, Thomsen and colleagues looked at grip and pinch strength, scar pain, pillar pain, function and symptom severity score according to the Boston Questionnaire (BQ) patient satisfaction and quality of life.
Investigators measured pressure in the thenar and hyperthenar areas to determine pillar pain. “We found that pillar pain was more pronounced in the hyperthenar area,” Thomsen said. There was a strong negative correlation with the 6 week measurements between pillar pain and grip strength in both groups, he said.
Results of the BQ results showed rapid resolution of symptoms in both groups.
“We know CTS surgery works very well,” and this and other studies have shown that diabetic patients do as well as most others, moderator Kevin C. Chung, MD, said when he reviewed Thomsen’s study.
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Reference:
- Niels O.B. Thomsen, MD, is senior consultant in the Department of Hand Surgery, Malmö University Hospital, SE 205 02 Malmö, Sweden. He can be reached at 46-40-33-1000; e-mail: niels.thomsen@med.lu.se. Chung and Thomsen have no direct financial interest in any products or companies mentioned in this article.
- Thomsen NOB, Cederlund R, Dahlin L. Clinical outcome of surgical release among diabetic patients with carpal tunnel syndrome: A prospective case controlled study. Paper #47. Presented at the American Society for Surgery of the Hand 63rd Annual Meeting. Sept. 18-20, 2008. Chicago.