Carpal tunnel release in the over 65's
An article shows patients over 65 still do well 5 years after Carpal Tunnel release
A recent study from Texas published in the American Journal of Hand Surgery (USA) demonstrated that patients over 65, achieved a significant clinical improvement at a five year review.
Although in the original study, 66 patients (92 hands) underwent carpal tunnel release, only 19 patients (29 hands) participated in the five-year review. The authors directed the five-year review on the patients' history, a physical hand examination and the status of the patients' hands since their carpal tunnel release procedure. In the patient's history, the Michigan Hand Outcomes Questionnaire allowed the authors to evaluate overall hand function and performance, whilst hand symptoms were assessed on a scale of 1 to 5 (5 being severe pain).
Carpal tunnel release reviews at five years, following on from the six-month reviews, demonstrated a significant decrease in symptoms in thehands of the patients.
There was a significant difference between symptoms of carpal tunnel release pre-op compared with five years post-op
However, there was no difference between symptoms at six months post-op and five years post-op, this is encouraging and suggests that the improvement remains. The patients' physical findings between this time period were unchanged suggesting the surgery is still successful, with the exception of grip strength. (Although there is no evidence to suggest this, possibilities for reduction in grip strength could potentially be due to aging of the patients and underlying osteoarthritis). All other physical examination tests also remained unchanged from the six-month review to the 5 year review. Only one patient had a repeat carpal tunnel release procedure conducted following the six-month review, due to the recurrent symptom of numbness.
Authors from this study reported 85% of right handed patients and 86% of left handed patients had complete satisfaction five years post-op, compared with 62% of right handed and 84% of left handed patients six months post-op.
This concludes clinical improvement of carpal tunnel release five years post-op was maintained in patients over 65 years of age.