CLINICAL AND FUNCTIONAL OUTCOMES BEFORE AND AFTER SURGERY IN PATIENTS WITH CARPAL TUNNEL SYNDROME
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Keywords
Clinical, Functional, Outcomes, Carpal Tunnel Syndrome
Abstract
The carpal tunnel is a narrow fibro-osseous passageway in the wrist that houses the median nerve and nine flexor tendons, facilitating hand and finger movement. This tunnel is structurally rigid, bordered on three sides by carpal bones and enclosed on the palmar side by the transverse carpal ligament (TCL), also known as the flexor retinaculum. Objective: Assess the clinical, functional outcomes of open carpal tunnel release surgery in CTS patients. Methods: This prospective study was conducted over 12 months in the Department of Orthopaedics, SHKM Government Medical College, Nalhar, Nuh, Harayana involving 23 patients with Carpal Tunnel Syndrome who were treated in the same department. Improvement was assessed based on grip strength, Quick Disabilities of the Arm, Shoulder, and Hand (Q-DASH) Score. Result: The study included 23 patients diagnosed with CTS, with a mean age of 53 years, and a mild male preponderance (56.5%). Most patients belonged to the 51–60 age group (43.5%), which aligns with previous research showing that middle-aged individuals are the most affected by CTS. Occupational exposure, repetitive hand use, and age-related degeneration were identified as contributing factors to CTS, while the condition showed no significant laterality preference (52.2% left hand vs. 47.8% right hand). Clinical assessment revealed that numbness, tingling, pain, and weakness in the median nerve distribution were the most commonly reported symptoms. The Phalen’s test, Tinel’s sign, and Durkan’s test were frequently positive, supporting the diagnosis of CTS. Preoperative grip strength was 26.91 ± 8.49 kg, which initially declined postoperatively due to surgical trauma (21.48 ± 7.153 kg at three weeks) but showed significant improvement by six months (30.13 ± 9.421 kg). Functional recovery was assessed using the QuickDASH questionnaire, a validated tool for evaluating upper limb disability. The preoperative QuickDASH score (66.26 ± 8.42) decreased significantly to 18.91 ± 4.58 at six months, reflecting marked functional improvement post- surgery. The statistically significant improvement reinforced the effectiveness of OCTR in reducing disability and restoring hand function.
Conclusion: This study demonstrated significant postoperative improvements in grip strength, and QuickDASH scores, confirming the clinical benefits of surgical decompression.
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Vineesh V
Postgraduate Resident, Department of Orthopaedics, Shaheed Hasan Khan Mewati Govt. Medical College Nalhar, Nuh, Haryana, India
H. S Madan
Associate Professor, Department of Orthopaedics, Shaheed Hasan Khan Mewati Govt. Medical College Nalhar, Nuh, Haryana, India
Sachin
Postgraduate Resident, Department of Orthopaedics, Shaheed Hasan Khan Mewati Govt. Medical College Nalhar, Nuh, Haryana, India
Arun I
'Postgraduate Resident, Department of Orthopedics, Government Stanley Medical College'
Pradhumam Pareek
Postgraduate Resident, Department of Orthopaedics, Shaheed Hasan Khan Mewati Govt. Medical College Nalhar, Nuh, Haryana, India