Study: Simultaneous bilateral carpal tunnel release has similar early outcomes as unilateral release

SAN FRANCISCO — Patients who had a simultaneous bilateral carpal tunnel release as part of a planned staged release showed no increased short-term impairment when compared to patients who received a unilateral release, according to results of this study presented at the American Society for Surgery of the Hand Annual Meeting, here.

“In conclusion, patients who undergo bilateral carpal tunnel release can anticipate 2 to 3 days of additional impairment, specifically with activities that require a heavier gripping or lifting such as cooking or household chores,” Daniel A. Osei, MD, stated in his presentation. “Surprisingly, despite the fact that patients who chose unilateral carpal tunnel release did so primarily due to worries about self-care, patients undergoing bilateral carpal tunnel release had no additional perceived difficulty with performing hygiene-related [activities of daily living] ADLs or nonmanual labor-related activities.”

Eighty-five patients with electrophysiological study-confirmed bilateral carpal tunnel syndrome received either a unilateral carpal tunnel release (CTR) or bilateral simultaneous CTR. They completed preoperative Quick–Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Levine Katz Symptom Severity questionnaires and a daily log to rate difficulty with activities of daily living for the first 7 postoperative days.

Researchers readministered QuickDASH and Levine Katz questionnaires at 7 days and 28 days after surgery. Patients also completed a survey at the 28-day follow-up to determine income loss.

At baseline, 7-day and 28-day follow-up, researchers found no significant difference in DASH scores between groups. However, according to study results, QuickDASH scores were significantly improved from baseline in both groups at 7 days and 28 days. During the first postoperative week, study results showed that mean activities of daily living scores were not significantly different. Overall, patients who underwent bilateral CTR had no greater levels of difficulty with activities required for independent living at all time points. Compared with 36% of patients in the bilateral group, 27% of patients in the unilateral group required assistance with personal hygiene. The researchers found that patients in the bilateral CTR group did not miss more days of work compared to the unilateral CTR group at 1 month after surgery.

Reference:

Osei DA. J Hand Surg Am. 2013;doi:10.1016/j.jhsa.2013.08.026.

Osei DA. Paper #21. Presented at: American Society for Surgery of the Hand Annual Meeting. Oct. 3-5, 2013; San Francisco.

Disclosures: Osei has no relevant financial disclosures.