PURPOSE: This study investigated the relationship between severity of symptoms and success of nonoperative and operative treatment in patients with carpal tunnel syndrome (CTS). METHODS: An observational cohort study regarding the management of CTS was conducted. Thirty patients referred to a tertiary hand centre with a diagnosis of CTS were prospectively followed. Twenty-five of the patients (47 affected hands) were available for long-term follow up to determine management outcomes. Self-report symptoms and physical impairments were assessed and documented at baseline, 6 weeks, and 12 weeks using the CTS Severity Score (SSS), the Disability-Shoulder, Arm and Hand Score (DASH), and the Levine Functional Score. Longer-term follow-up was conducted to identify status on outcome measures and whether patients proceeded to surgery. RESULTS: Those who proceeded to surgery (n = 27/47 hands) had higher initial CTS SSS and DASH scores and also maintained higher scores compared to those who improved with conservative management (p < 0.05). Improvements occurred in the SSS (P < 0.0001), Functional Score (P < 0.001), and DASH score (P < 0.05) following surgery in the patients resistant to conservative management. Recovery of grip and dexterity was less satisfactory. DISCUSSION: This study suggests that the SSS is useful in the triage of patients on surgical wait-lists as patients with high initial scores or failure to change in short-term follow-up are likely to proceed to surgical release. Despite prolonged symptoms and previous treatment, patients with lower SSS scores had moderate success with a second trial of conservative management.
PURPOSE: This study investigated the relationship between severity of symptoms and success of nonoperative and operative treatment in patients with carpal tunnel syndrome (CTS). METHODS: An observational cohort study regarding the management of CTS was conducted. Thirty patients referred to a tertiary hand centre with a diagnosis of CTS were prospectively followed. Twenty-five of the patients (47 affected hands) were available for long-term follow up to determine management outcomes. Self-report symptoms and physical impairments were assessed and documented at baseline, 6 weeks, and 12 weeks using the CTS Severity Score (SSS), the Disability-Shoulder, Arm and Hand Score (DASH), and the Levine Functional Score. Longer-term follow-up was conducted to identify status on outcome measures and whether patients proceeded to surgery. RESULTS: Those who proceeded to surgery (n = 27/47 hands) had higher initial CTS SSS and DASH scores and also maintained higher scores compared to those who improved with conservative management (p < 0.05). Improvements occurred in the SSS (P < 0.0001), Functional Score (P < 0.001), and DASH score (P < 0.05) following surgery in the patients resistant to conservative management. Recovery of grip and dexterity was less satisfactory. DISCUSSION: This study suggests that the SSS is useful in the triage of patients on surgical wait-lists as patients with high initial scores or failure to change in short-term follow-up are likely to proceed to surgical release. Despite prolonged symptoms and previous treatment, patients with lower SSS scores had moderate success with a second trial of conservative management.
Authors: Erika D Sears; Esther L Meerwijk; Eric M Schmidt; Eve A Kerr; Kevin C Chung; Robin N Kamal; Alex H S Harris Journal: J Hand Surg Am Date: 2018-12-20 Impact factor: 2.230
Authors: Christina Jerosch-Herold; Lee Shepstone; Edward C F Wilson; Tony Dyer; Julian Blake Journal: BMC Musculoskelet Disord Date: 2014-02-07 Impact factor: 2.362
Authors: Ruth Getachew; Sunghoon I Lee; Jon A Kimball; Andrew Y Yew; Derek S Lu; Charles H Li; Jordan H Garst; Nima Ghalehsari; Brian H Paak; Mehrdad Razaghy; Marie Espinal; Arsha Ostowari; Amir A Ghavamrezaii; Sahar Pourtaheri; Irene Wu; Majid Sarrafzadeh; Daniel C Lu Journal: J Neuroeng Rehabil Date: 2014-08-13 Impact factor: 4.262