Carpal Tunnel Release in Diabetic and Non-Diabetic Patients

Document Type: RESEARCH PAPER

Authors

1 Orthopedic Research Center, Ghaem Department of Nerosurgery

2 Department of Nerosurgery, Ghaem Hospital, Mashhad University of Medical Science, Mashhad, 91766-99199, Iran.

3 Research Center, Ghaem Hospital, Mashhad University of Medical Science, Mashhad, 91766-99199, Iran.

4 Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Science, Mashhad, 91766-99199, Iran.

Abstract

Background: Carpal tunnel syndrome (CTS) is a compression neuropathy that causes paresthesia, pain or numbness in the territory of median nerve. The aim of this study is to compare the open surgery outcome and patients` satisfaction in carpal tunnel syndrome among diabetic and non-diabetic patients.
Methods: In a retrospective cohort study from April 2011 to June 2012, patients suffered from carpal tunnel syndrome at least 6 months, without response to conservative treatment, who had the inclusion and exclusion criteria, were evaluated by the usage of MHQ and WHOQOL-BREEF tests, one month before surgery and three months after that. Carpal tunnel decompression surgery was performed by two surgeons, experienced in hand surgery, which used the same surgical method. Statistical analysis was performed by SPSS 19.0.
Results: 24 of patient (34.2%) were male and 46 (65.8%) were female and there was no significant difference between two groups (P>0.05). MHQ total score before and after surgery was respectively 50.22±7.13 and 63.49±11.28 and this difference was significant (P<0.05). In WHOQOF-BREEF parameters, physical parameters (36.81±19.8 vs. 55.30±24.36) and psychological parameters (41.64±14.77 vs. 61.24±19.9) improved significantly after surgery. Conclusion: The outcome of carpal tunnel syndrome open surgery is good in both men and women, but diabetes has a negative impact on surgery outcome in short term.

Keywords


Burt S, Crombie K, Jin Y, Wurzelbacher S, Ramsey J, Deddens J. Workplace and individual risk factors for carpal tunnel syndrome. Occup Environ Med. 2011;68(12):928-33.

  • Singh R, Gamble G, Cundy T. Lifetime risk of symptomatic carpal tunnel syndrome in Type 1 diabetes. Diabet Med. 2005; 22:625-30.

  • Randall LB, Ralph MB, Leighton C. Physical Medicine & Rehabilitation. 3rd ed. Philadelphia: Elsevier Saunders; 2007:1079-80.

  • Werner RA, Albers JW, Franzblau A, Armstrong TJ. The relationship between body mass index and the diagnosis of carpal tunnel syndrome. Muscle Nerve. 1994;17(6):632-6.

  • De Krom M, De Krom C, Spaans F. Carpal tunnel syndrome: Diagnosis, treatment, prevention and its relevance to dentistry. Ned Tijdschr Tandheelkd. 2009;116:97–101.

  • Yeo KQ, Yeo EM. Comparison of the results of open carpal tunnel release and KnifeLight carpal tunnel release. Singapore Med J. 2007; 48(12):1131-5.

  • Uchiyama S, Imaeda T, Toh S, Kusunose K, Sawaizumi T, Wada T, et al. Comparison of responsiveness of the Japanese Society for Surgery of the Hand version of the carpal tunnel syndrome instrument to surgical treatment with DASH, SF-36, and physical findings. J Orthop Sci. 2007;12(3):249-53.

  • Yousefy AR, Ghassemi GR, Sarrafzadegan N, Mallik S, Baghaei AM, Rabiei K. Psychometric properties of the WHOQOL-BREF in an Iranian adult sample. Community Ment Health J. 2010;46(2):139-47.

  • Al-Homood IA. Rheumatic conditions in patients with diabetes mellitus. Clin Rheumatol. 2013;32(5):527-33.

  • Aslani HR, Alizadeh K, Eajazi A, Karimi A, Karimi MH, Zaferani Z, et al. Comparison of carpal tunnel release with three different techniques. Clin Neurol Neurosurg. 2012;114(7):965-8.

  • Louie DL, Earp BE, Collins JE, Losina E, Katz JN, Black EM, et al. Outcomes of open carpal tunnel release at a minimum of ten years. J Bone Joint Surg Am. 2013;95(12):1067-73.

  • Song CH, Gong HS, Bae KJ, Kim JH, Nam KP, Baek GH. Evaluation of female hormone-related symptoms in women undergoing carpal tunnel release. J Hand Surg Eur Vol. 2014; 39(2): 155-60.

  • Yazdanpanah P, Aramesh S, Mousavizadeh A, Ghaffari P, Khosravi Z, Khademi A. Prevalence and severity of carpal tunnel syndrome in women. Iran J Public Health. 2012;41(2):105-10.

  • Karthik K, Nanda R, Stothard J. Recurrent carpal tunnel syndrome--analysis of the impact of patient personality in altering functional outcome following a vascularised hypothenar fat pad flap surgery. J Hand Microsurg. 2012; 4(1):1-6.

  • Becker J, Nora DB, Gomes I, Stringari FF, Seitensus R, Panosso JS, et al. An evaluation of gender, obesity, age and diabetes mellitus as risk factors for carpal tunnel syndrome. Clin Neurophysiol. 2002; 113(9):1429-34.