Evaluation of Clinical and Nerve Coduction Study for Surgical Treatment of Carpal Tunnel Syndrome

Abstract

Background: Carpal tunnel syndrome (CTS)is very commonly encountered in surgical practice. The syndrome is more common in women ages 30-60 and for those with jobs that require frequent, repetitive hand movement. Aim of the study: To assess the improvement in the clinical and nerve conductivity in the first and six months after surgery. Methods: This prospective study was carried out in different hospitals in Iraq on 30 patients. Twenty – six of them were female, and four were male. Seventy-six percent were stay-at-home parents. The mean age was (38.56± 6.68). In 18 patients, the dominant hand was affected. All patients complained of pain, paraesthesia, and numbness in the distribution of the median nerve. The nerve conduction study was abnormal in 25 patients. The thenar muscle wasting was positive only in 12 patients; also two–point discrimination was abnormal in 12 patients. Those patients have long duration and severe symptoms. All the Patients were treated by surgical decompression of the median nerve. Results and Discussion: Twenty-three of them improved clinically in one month postoperatively, while the nerve conduction study became normal only in 12 patients. In six months postoperatively, only seven patients remained complaining about mild symptoms, and only five patients still have abnormal nerve conduction study. We conclude that adequate surgery usually gives an excellent result. The nerve recovery in a nerve conduction study takes time longer than clinical improvement. Conclusion: 1) CTS affect middle-aged female, especially in housewife. 2) The dominant hand is more affected than the other hand. 3) Nerve conduction study confirmed the diagnosis of CTS. 4) Adequate surgery usually gives good results. 5) Most of the patients with abnormal nerve conduction studies pre-operatively show excellent results and improve clinically post-operatively with nerve conduction study become completely normal. 6) Muscle wasting did not improve in most patients, especially those who had a long duration of symptoms.