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Chirurgie 24. Oktober 2013

Postoperative care and rehabilitation after open carpal tunnel surgery

Background: Carpal tunnel syndrome is the most commonly diagnosed and treated entrapment neuropathy. The most frequently performed procedure in the surgical treatment is the open release of the flexor retinaculum. Regarding postoperative care, current literature is inconclusive and does not meet the necessary requirements to create a consensus on rehabilitation regimen. Although postoperative splinting is common among hand surgeons and most often applied for 1 week, none of the previous studies have especially assessed the outcome after 7 days of splinting.

Methods: The aim of this study was to investigate the differences in postoperative rehabilitation following open carpal tunnel release, between a regimen of 1 week dorsal splinting and a light foam bandage for 2 days.

Results: Sixty patients undergoing carpal tunnel surgery were enrolled in this prospective, noninterventional study. After either receiving a lightweight foam dressing or a splint, patients were followed up at 3 and 6 months, retrieving parameters of pain, two-point discrimination, grip, pinch and keypinch strength, and electrodiagnostic studies.

Conclusions: Significant improvements were observed in both groups, regardless of the respective postoperative care. A comparison of follow-up data between the two study groups did not show any significant differences. Though, statistically significance was detected when comparing grip (5.42 ± 7.35 vs. −0.19 ± 5.88; p = 0.001) and keypinch strength differences (2.38 ± 5.39 vs. −0.06 ± 3.30; p = 0.035) at 6 months, favoring nonsplinted individuals.
The results of our research yield little benefit of unrestricted mobility in relation to 1 week postoperative splinting. Immobilization does not entail advantages and thus should be limited to certain circumstances only.

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