Rehabilitation of carpal tunnel surgery patients using a short surgical incision and an early program of physical therapy.

One goal of surgery for carpal tunnel syndrome is to return the patient to work or full-time activities in the shortest possible period of time. The authors evaluated the effectiveness of two incisions, a short incision less than 2.5 cm and an incision greater than 2.5 cm, both combined with a program of active postoperative hand-therapy in a group of 216 patients (293 release). When compared to other techniques with or without active physical therapy, our combined program achieved as short a median return-to-work interval as any other method, both for workers' compensation patients (21 days) and for private/Medicare/welfare patients (10 days). The operating time averaged 7 minutes, and postoperative complications were few. The findings suggest that early hand therapy is more important than the short incision for minimizing the interval for regaining normal function and for decreasing the time-loss cost.