FACTORS ASSOCIATED WITH POOR OUTCOME FOLLOWING PRIMARY CARPAL-TUNNEL RELEASE IN NONDIABETIC PATIENTS

A retrospective study was performed of 112 non-diabetic patients (133 hands) who had open surgical treatment for carpal tunnel syndrome, to determine the factors associated with poor outcome. None of the patien ts had a previous carpal tunnel release and all had a positive nerve c onduction study to confirm the clinical diagnosis of carpal tunnel syn drome. Outcome was assessed at least 18 months after surgery and class ified as excellent, good or poor. Outcome was deemed poor when symptom s were minimally improved, unchanged or woerse after surgery. This occ urred in 13.5% of treated hands. There was a higher chance of poor out come in patients with physically strenuous work activities. All these heavy or repetitive manual workers were also involved in compensation and their poor outcome correlated with their inability to return to th eir original work. Other predisposing factors, associated hand conditi ons, duration of symptoms prior to surgery, the presence of bilateral or nocturnal symptoms, and the severity of the preoperative nerve cond uction deficit did not affect the final outcome after surgery.