Page 75 - GTM-2-4

Global Translational Medicine Open carpal tunnel release surgical outcomes

were treated with revision carpal tunnel release, and the The result of this study showed no significant
rest were provided symptomatic relief). Finally, 4 patients relationship (P = 0.194) between the presence of post-
(1.5%) reported dissatisfaction with the operation due to operative complications and BMI (Table 4). However,
the persistence of symptoms without notable improvement a statistically significant (P = 0.011) relationship was
in their hands. A summary of these findings is presented observed between the severity of NCS and the occurrence
in Table 2. of post-operative complications (Table 5).
The post-operative follow-up revealed a statistically 4. Discussion
significant reduction in dull aching discomfort in the
hand and forearm, as well as paresthesia and numbness Carpal tunnel release is a well-established treatment
when compared to the pre-operative period (10.2% vs. modality for patients with CTS. A variety of techniques,
90.5%; P < 0.0001). However, no significant differences including endoscopic and OCTR, have been advocated for
were observed during the follow-up compared to the pre- this purpose. OCTR is typically considered when minimally
operative assessment in terms of the clumsiness associated invasive measures prove insufficient in achieving effective
with CTS (18.8% vs. 25.8%; P = 0.256) and the presence of CTS management through median nerved compression.
thenar muscle atrophy (1.6% vs. 5.0%; P = 0.194), as shown To the best of our knowledge, this study represents the first
in Table 3). prospective investigation conducted in Libya to explore the

Table 2. Postoperative outcomes and complications of OCTR surgery
Clinical presentation during post‑operative follow‑up Frequency (n=256) Percent (%)
No recurrence or complication 232 90.6
Recurrent CTS 15 5.9
Wound infections 5 2.0
Persistent symptoms with no improvement 4 1.5
Abbreviations: CTS: Carpal tunnel syndrome; OCTR: Open carpal tunnel release.

Table 3. Comparison of CTS symptoms at the pre‑operative stage versus post‑operative follow‑up

Symptoms Pre‑operative stage Post‑operative follow‑up ² statistic P‑value a
(n [%]) (n [%]) (df)
Yes No Yes No
Dull aching discomfort in the hand and 243 (95.0) 13 (5.1) 26 (10.2) 230 (89.8) 9.04 (1) 0.000*
forearm with hand paraesthesia and numbness
Clumsiness 66 (25.8) 190 (74.2) 48 (18.8) 208 (81.3) 6.01 (1) 0.256
Thenar muscle atrophy 13 (5.0) 243 (95.0) 4 (1.6) 252 (98.4) 5.82 (1) 0.194
Notes: McNemar’s test; *P<0.05. CTS: Carpal tunnel syndrome.
a
Table 4. Differences in BMI between patients with and without post‑operative complications

Post‑operative complications n (%) Mean BMI (SD) t‑statistic P‑value a
Yes 24 (9.4) 28.6 (13.8) 1.98 (165) 0.143
No 232 (90.6) 25.8 (12.5)
Note: Independent t-test. BMI: body mass index; SD: Standard deviation.
a
Table 5. Association between NCS severity and post‑operative complications
Post‑operative complications n (%) NCS severity ² statistic (df) P‑value a
Severe (n [%]) Mild–moderate (n [%])
Yes 24 (9.4) 19 (79.2) 5 (20.8) 5.93 (1) 0.011*
No 232 (90.6) 111 (47.8) 121 (52.2)
Notes: Chi-square test; *P<0.05. NCS: Nerve conduction studies.
a

Volume 2 Issue 4 (2023) 5 https://doi.org/10.36922/gtm.1019