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Subjective and functional outcome after revision surgery in carpal tunnel syndrome

Frank Unglaub, Elke Wolf, Claudia Goldbach, Peter Hahn & Markus Kroeber

abstract INTRODUCTION: In spite of carpal tunnel release's prevalent good postoperative results, the number of revision surgeries needed should not be underestimated. In this study, subjective and functional results after carpal tunnel revision surgery were determined. MATERIALS AND METHODS: Thirty-eight patients were examined approximately 2 years after their revision surgery of the carpal tunnel release. The subjective outcome of the patients was assessed using two different questionnaires (Amadio and DASH). A clinical examination was undertaken on selected patients who had persistent complaints. The clinical assessment analyzed grip strength, thumb opposition, pulp-to-pulp-pinch, key-pinch, hook-grip, Moberg-Pickup-test, two-point-discrimination, Phalen-test, and the Hoffmann-Tinel-sign. RESULTS: The subjective assessment showed that after the revision surgery, patients experienced load induced pain that occurred during daytime. However, the revision was able to improve the impaired sensibility. The functional outcome showed a persistent lack of strength when performing daily activities. The clinical assessment of the patients with relevant complaints confirmed the subjective outcome. CONCLUSION: The revision surgery can improve the impaired sensibility, particularly, paresthesia nocturna. The persistent weakness of the hand can only partly be improved. In spite of remaining complaints, revision surgery can yield satisfactory results for the patients.
   
citation Unglaub F, Wolf E, Goldbach C, Hahn P, kroeber m. Subjective and functional outcome after revision surgery in carpal tunnel syndrome. Archives of orthopaedic and trauma surgery 2008; 128:931-6.
   
type journal paper/review (English)
date of publishing 9-2008
journal title Archives of orthopaedic and trauma surgery (128/9)
ISSN print 0936-8051
pages 931-6
PubMed 17874323
DOI 10.1007/s00402-007-0451-3