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Global Translational Medicine Open carpal tunnel release surgical outcomes

surgical outcomes of OCTR among CTS patients seeking Our study observed that 5.9% of patients presented with
treatment at Zliten Teaching Hospital. recurrent symptoms, and 1.5% experienced persistent
In general, the implementation of OCTR procedures symptoms even after the operation. A large-scale study
in CTS patients yielded favorable results during the involving 2053 open carpal tunnel decompressions
post-operative follow-up. Surgical and post-surgical revealed that only 34 patients (1.6% of cases) required
[21]
photographs of the hand of a female patient are presented re-exploration due to symptom recurrence . However,
for reference in Figures 1 and 2, respectively. it is worth noting that contrasting findings have been
reported in other studies, with recurrent symptoms of
Approximately 9.4% of our study participants CTS in approximately 19% of patients following OCTR,
experienced postoperative complications, while 90.6% with up to 12% requiring re-exploration [18,22-24] . A study
were highly satisfied with the results of the open release, conducted in Iran reported an incidence of 12.4%
reporting no recurrence symptoms. The review by for recurrent CTS and 10.4% for persistent CTS after
Kuschner et al. noted an overall complication rate ranging OCTR . Furthermore, other studies have reported that
[18]
from 1% to 2% . In a study by Kulick et al., 4.6% of 130 these symptoms can persist or recur in up to 30% of
[19]
hands treated with the open release technique developed cases following surgery, and such cases are more likely to
recurrent symptoms during post-operative follow-up . develop post-operative complications [24,25] . Therefore, it is
[20]
evident that several patients prefer conservative treatments
over surgical procedures due to their minimally invasive
nature . A previous study has documented several post-
[26]
surgical adverse effects, including infections, painful or
hypertrophic scars, wound hematomas, edema, wrist
discomfort, stiffness, and reflex sympathetic dystrophy,
affecting approximately 56.6% of CTS patients . In
[27]
comparison, our study identified only 2% of patients
presenting with superficial wound infections, indicative of
effective post-operative management by the hospital staff
while treating the patients. The correlation between post-
operative complications, symptom persistence, and partial
median nerve decompression has been noted . These
[18]
findings support the effectiveness of our surgical strategy,
contributing to the low complication and recurrence rates
observed in our study. It is important to recognize that an
Figure 1. A photograph of the hand of a 53-year-old female patient with increased incidence of complications and recurrence of
hyperemic median nerve during an open carpal tunnel release surgical symptoms occur after surgical failures, primarily attributed
procedure.
to diagnostic errors in the cases involving double crush in
nerve entrapment syndromes, median nerve tumors, and
iatrogenic injuries .
[28]
The discrepancy observed in the outcomes of
various studies can be attributed to the demographic
characteristics of the study participants. The previous
literature has indicated that CTS is more prevalent among
specific demographic groups, including women, obese
individuals and middle-aged individuals , those with
[14]
[15]
metabolic and degenerative conditions , and certain
[5]
occupational groups with repetitive wrist movements .
[29]
For instance, a review article discussed a study involving
60 patients treated with the open release technique, reporting
that only one patient required CTS revision surgery during
a mean follow-up period of 5.5 years . In contrast, our
[30]
study reported three revision operations within a 2-year
Figure 2. A photograph of the hand of the patient post-surgery (1-year follow-up period. The primary factors contributing to CTS
follow-up). recurrence included inadequate surgical skill, incorrect

Volume 2 Issue 4 (2023) 6 https://doi.org/10.36922/gtm.1019