Purpose
The aim of this study was to determine factors associated with presentation of carpal
tunnel syndrome for carpal tunnel release (CTR) in the advanced electrodiagnostic
stages.
Methods
We identified 920 patients with preoperative electrodiagnostic studies (EDSs) who
underwent CTR at a tertiary-care referral center from July 2008 to June 2013. Patients
were divided into 2 groups: those in the advanced electrodiagnostic stage, defined
as those with unrecordable nerve potentials on preoperative EDSs (group 1), and those
with recordable nerve potentials on preoperative EDSs (group 2). Logistic regression
was used to determine factors that were associated with presentation in the advanced
stages of the disease.
Results
Multivariable regression analysis showed older age (odds ratio [OR] 1.05; 95% confidence
interval [95% CI], 1.04–1.07), diabetes mellitus (OR, 1.72; 95% CI, 1.13–2.62), and
hypertension (OR, 1.88; 95% CI, 1.25–2.84) to be associated with advanced presentation
for CTR.
Conclusions
A 10-year increase in age results in a 1.6-times increase in the odds of advanced
presentation. Diabetes mellitus or hypertension independently doubles the odds of
advanced presentation. A subset of symptomatic patients with carpal tunnel syndrome
may benefit from earlier referral for hand surgery evaluation and earlier CTR. Older
patients with diabetes mellitus and hypertension are at increased risk for advanced
presentation.
Type of study/level of evidence
Therapeutic II.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Hand SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Maine Carpal Tunnel Study: outcomes of operative and nonoperative therapy for carpal tunnel syndrome in a community-based cohort.J Hand Surg Am. 1998; 23: 697-710
- Outcomes of open carpal tunnel release at a minimum of ten years.J Bone Joint Surg Am. 2013; 95: 1067-1073
- Pre-operative electrodiagnostic testing predicts time to resolution of symptoms after carpal tunnel release.J Hand Surg Eur Vol. 2016; 41: 137-142
- Prognosis of severe carpal tunnel syndrome with absent compound muscle action potential.Muscle Nerve. 2016; 54: 427-431
- Clinical results in severe carpal tunnel syndrome and motor nerve conduction studies.J Orthop Sci. 2005; 10: 22-26
- Electrodiagnostic testing and carpal tunnel release outcome.J Hand Surg Am. 1996; 21: 117-121
- Electrodiagnostic grade and carpal tunnel release outcomes: a prospective analysis.J Hand Surg Am. 2018; 43: 425-431
- Predicting clinical outcome after surgical treatment in patients with carpal tunnel syndrome.J Hand Surg Am. 2018; 43: 1098-1106.e1
- The benefit of carpal tunnel release in patients with electrophysiologically moderate and severe disease.J Hand Surg Am. 2015; 40: 438-444.e1
- Mental and physical health disparities in patients with carpal tunnel syndrome living with high levels of social deprivation.J Hand Surg Am. 2019; 44: 335.e1-335.e9
- Results of treatment of severe carpal tunnel syndrome.J Hand Surg Am. 1992; 17: 1020-1023
- Surgical demographics of carpal tunnel syndrome and cubital tunnel syndrome over 5 years at a single institution.J Hand Surg Am. 2017; 42: 929.e1-929.e8
- Carpal tunnel syndrome in patients with diabetic polyneuropathy.Diabetes Care. 2002; 25: 565-569
- Comparative histopathological evaluation of patients with diabetes, hypothyroidism and idiopathic carpal tunnel syndrome.Turk Neurosurg. 2017; 27: 991-997
- Recent advances in the pathogenesis of diabetic neuropathy.Muscle Nerve. 1987; 10: 121-128
- Capillary number and percentage closed in human diabetic sural nerve.Proc Natl Acad Sci U S A. 1985; 82: 2513-2517
- Association between cardiovascular risk factors and carpal tunnel syndrome in pooled occupational cohorts.J Occup Environ Med. 2016; 58: 87-93
- Outcome after carpal tunnel release: impact of factors related to metabolic syndrome.J Plast Surg Hand Surg. 2017; 51: 165-171
- A prognostic model for the patient reported outcome of surgical treatment of carpal tunnel syndrome.Muscle Nerve. 2018; 58: 784-789
Article info
Publication history
Published online: October 24, 2019
Accepted:
August 23,
2019
Received:
December 6,
2018
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2020 by the American Society for Surgery of the Hand. All rights reserved.
