Surgical management of carpal tunnel syndrome with an open carpal tunnel release-our experience

Abstract

Introduction: CTS (Carpal tunnel syndrome) is characterised by compression of the median nerve at the wrist joint and is quite commonly seen in orthopaedic practice. Surgical management with release of the transverse carpal ligament is the most commonly performed modality of treatment and this study was performed to assess the functional outcome after open release of the carpal tunnel. Methods: This study included 30 patients with CTS managed by open carpal tunnel release done between January 2014 to January 2017. The patients were evaluated for functional outcome using the DASH (Disabilities of arm, shoulder and hand) and GSS (Global symptom score) scores. Results: There were 14 males and 16 females with the left wrist involvement seen more as compared to the right side. The patients age was a mean of 42.4 years (33-54 years). The average duration of the surgical procedure was 36 minutes (22-48 minutes) and the mean blood loss was 20.2 ml (18-28 ml). There was a good improvement in the DASH and the GSS scores postoperatively which were statistically significant. We were able to provide good functional outcomes to the patients with minimal complications. Conclusion: Open surgical carpal tunnel release facilitates release of the carpal ligament under direct visualization and hence complications such as iatrogenic median nerve injury which can be associated with minimally invasive methods can be avoided. It offers good resolution of symptoms to the patients and provides a good functional outcome enabling a faster return to work related activity as well as day to day living.