AccScience Publishing / GTM / Online First / DOI: 10.36922/gtm.1019
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ORIGINAL RESEARCH ARTICLE

Surgical outcome of open carpal tunnel release: A 2-year case series study at Zliten Teaching Hospital, Libya

Mohamed Gwila1,2* ,  Mostafa Ebshina2 ,  Syeda Humayra3 ,  Moniruddin Chowdhury3,4
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1 Department of Orthopaedics and Traumatology, Faculty of Medicine, Al Asmarya Islamic University, Zliten, Libya
2 Department of Orthopaedics, Zliten Teaching Hospital, Zliten, Libya
3 Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University, Daffodil Smart City, Birulia, Dhaka, Bangladesh
4 Department of Medicine, Faculty of Medicine, AIMST University, Bedong, Kedah, Malaysia
Global Translational Medicine 2023, 2(4), 1019 https://doi.org/10.36922/gtm.1019
Submitted: 30 May 2023 | Accepted: 7 October 2023 | Published: 6 November 2023
© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Carpal tunnel syndrome (CTS) is the most commonly diagnosed peripheral neuropathy, with a prevalence of 1 – 16% within the general population. If left untreated, it can lead to permanent dysfunctionality and disability. This study aimed to determine the outcomes and complications associated with open carpal tunnel release surgery (OCTR), compare the presentation of CTS symptoms before and after the operation, and investigate the factors contributing to post-operative complications. To achieve these objectives, a case series design was employed, and the study was conducted at the Department of Orthopedics and Traumatology in Zliten Teaching Hospital, Libya, from January 2016 to December 2018. A total of 256 patients who had opted to undergo OCTR of the transverse carpal ligament during the preoperative stage were enrolled and prospectively followed up for 2 years. The post-operative follow-up analysis revealed a statistically significant reduction in symptoms such as dull aching discomfort in the hand and forearm, as well as paresthesia and numbness when compared to the pre-operative period (10.2% vs. 90.5%; P < 0.0001). However, there were no significant differences in clumsiness (18.8% vs. 25.8%; P = 0.256) or thenar muscle atrophy (1.6% vs. 5.0%; P = 0.194). The majority of the patients (90.6%) expressed high levels of satisfaction with the procedure, reporting no recurrence of symptoms. In contrast, only 9.4% of patients experienced post-operative complications. The study findings revealed no significant correlation between post-operative complications and body mass index (P = 0.194). Nonetheless, a statistically significant association was observed between the severity of nerve conduction and post-operative complications (P = 0.011). In summary, the open release of the transverse carpal ligament resulted in positive surgical outcomes.

Keywords
Carpal tunnel syndrome
Libya
Open release
Outcomes
Surgery
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
References
  1. Ibrahim I, Khan W, Goddard N, et al., 2012, Carpal tunnel syndrome: A review of the recent literature. Open Orthop J, 6: 69–76. https://doi.org/10.2174/1874325001206010069

 

  1. Sevy JO, Varacallo M, 2022, Carpal tunnel syndrome. In: Statpearls. Available from: https://www.ncbi.nlm.nih.gov/ books/NBK448179 [Last accessed on 2022 Dec 28].

 

  1. Alimohammadi E, Bagheri SR, Hadidi H, et al., 2020, Carpal tunnel surgery: Predictors of clinical outcomes and patients’ satisfaction. BMC Musculoskelet Disord, 21: 51. https://doi.org/10.1186/s12891-020-3082-2

 

  1. Carpal Tunnel Syndrome: Clinical Manifestations and Diagnosis, 2022, UpToDate. Available from: https://www. uptodate.com/contents/carpal-tunnel-syndrome-clinical-manifestations-and-diagnosis/print [Last accessed on 2022 Dec 28].

 

  1. Habib R, Alam D, Islam RN, et al., 2016, Electrophysiological grading to assess the severity of carpal tunnel syndrome in symptomatic diabetic patients. Bangladesh J Neurosci, 32: 98–105. https://doi.org/10.3329/bjn.v32i2.57447

 

  1. Carpal Tunnel Syndrome - Symptoms and Causes, 2022, Mayo Clinic. Available from: https://www.mayoclinic.org/ diseases-conditions/carpal-tunnel-syndrome/symptoms-causes/syc-20355603 [Last accessed on 2022 Dec 28].

 

  1. Carpal Tunnel Syndrome Fact Sheet, 2022, National Institute of Neurological Disorders and Stroke. Available from: https://www.ninds.nih.gov/carpal-tunnel-syndrome-fact-sheet [Last accessed on 2022 Dec 30].

 

  1. Chung KC, 2006, Current status of outcomes research in carpal tunnel surgery. Hand, 1: 9–13. https://doi.org/10.1007/s11552-006-0002-3

 

  1. Faucher GK, Daruwalla JH, Seiler JG, 2017, Complications of surgical release\break of carpal tunnel syndrome: A systematic review. J Surg Orthop Adv, 26: 18–24.

 

  1. Li Y, Luo W, Wu G, et al., 2020, Open versus endoscopic carpal tunnel release: A systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord, 21: 272. https://doi.org/10.1186/s12891-020-03306-1

 

  1. Wong KC, Hung LK, Ho PC, et al., 2003, Carpal tunnel release. A prospective, randomised study of endoscopic versus limited-open methods. J Bone Joint Surg, 85: 863–868. https://doi.org/10.1302/0301-620X.85B6.13759

 

  1. Michelotti BM, Vakharia KT, Romanowsky D, et al., 2020, A prospective, randomized trial comparing open and endoscopic carpal tunnel release within the same patient. Hand (N Y), 15: 322–326. https://doi.org/10.1177/1558944718812129

 

  1. Lee WA, Strickland JW, 1998, Safe carpal tunnel release via a limited palmar incision: Plastic and reconstructive surgery. Plast Reconstr Surg, 101: 418–424. https://doi.org/10.1097/00006534-199802000-00025

 

  1. Cazares-Manríquez MA, Wilson CC, Vardasca R, et al., 2020, A review of carpal tunnel syndrome and its association with age, body mass index, cardiovascular risk factors, hand dominance, and sex. Appl Sci, 10: 3488. https://doi.org/10.3390/app10103488

 

  1. Rahaman MM, Ali Z, Hossain SM, et al., 2021, Association of body mass index with carpal tunnel syndrome. BIRDEM Med J, 11: 179–185. https://doi.org/10.3329/birdem.v11i3.55216

 

  1. Srikanteswara PK, Cheluvaiah JD, Agadi JB, et al., 2016, The relationship between nerve conduction study and clinical grading of carpal tunnel syndrome. J Clin Diagn Res, 10: OC13–OC18. https://doi.org/10.7860/JCDR/2016/20607.8097

 

  1. Ise M, Saito T, Katayama Y, et al., 2021, Relationship between clinical outcomes and nerve conduction studies before and after surgery in patients with carpal tunnel syndrome. BMC Musculoskelet Disord, 22: 882. https://doi.org/10.1186/s12891-021-04771-y

 

  1. Yazdanpanah P, Mohamadi H, Mousavizadeh A, et al., 2015, Incidence of recurrent and persistent carpal tunnel syndrome following open transverse carpal ligament release. Zahedan J Res Med Sci, 17(1): e1923.

 

  1. Kuschner SH, Brien WW, Johnson D, et al., 1991, Complications associated with carpal tunnel release. Orthop Rev, 20: 346–352.

 

  1. Kulick MI, Gordillo G, Javidi T, et al., 1986, Long-term analysis of patients having surgical treatment for carpal tunnel syndrome. J Hand Surg Am, 11: 59–66. https://doi.org/10.1016/s0363-5023(86)80104-6

 

  1. Langloh ND, Linscheid RL, 1972, Recurrent and unrelieved carpal-tunnel syndrome. Clin Orthop Relat Res, 83: 41–47. https://doi.org/10.1097/00003086-197203000-00008

 

  1. Botte MJ, von Schroeder HP, Abrams RA, et al., 1996, Recurrent carpal tunnel syndrome. Hand Clin, 12: 731–743.

 

  1. Concannon MJ, Brownfield ML, Puckett CL, 2000, The incidence of recurrence after endoscopic carpal tunnel release. Plast Reconstr Surg, 105: 1662–1665. https://doi.org/10.1097/00006534-200004050-00010

 

  1. Neuhaus V, Christoforou D, Cheriyan T, et al., 2012, Evaluation and treatment of failed carpal tunnel release. Orthop Clin North Am, 43: 439–447. https://doi.org/10.1016/j.ocl.2012.07.013

 

  1. Uchiyama S, Itsubo T, Nakamura K, et al., 2010, Current concepts of carpal tunnel syndrome: Pathophysiology, treatment, and evaluation. J Orthop Sci, 15: 1–13. https://doi.org/10.1007/s00776-009-1416-x

 

  1. Meems M, Boekhorst MGBM, Pop VJM, 2021, Long-term follow-up results of mechanical wrist traction as non-invasive treatment for carpal tunnel syndrome. Front Neurol, 12: 668549. https://doi.org/10.3389/fneur.2021.668549

 

  1. Gerritsen AAM, De Vet HCW, Scholten RJPM, et al., 2002, Splinting vs surgery in the treatment of carpal tunnel syndrome: A randomized controlled trial. JAMA, 288: 1245– 1251. https://doi.org/10.1001/jama.288.10.1245

 

  1. Pripotnev S, Mackinnon SE, 2022, Revision of carpal tunnel surgery. J Clin Med, 11: 1386. https://doi.org/10.3390/jcm11051386

 

  1. Eroğlu A, Sari E, Topuz AK, et al., 2018, Recurrent carpal tunnel syndrome: Evaluation and treatment of the possible causes. World J Clin Cases, 6: 365–372. https://doi.org/10.12998/wjcc.v6.i10.365

 

  1. Louie D, Earp B, Blazar P, 2012, Long-term outcomes of carpal tunnel release: A critical review of the literature. Hand (N Y), 7: 242–246. https://doi.org/10.1007/s11552-012-9429-x

 

  1. Zaussinger M, Radtke C, 2021, Revision carpal tunnel release: Risk factors and rate of secondary surgery. Plast Reconstr Surg, 148: 308e–309e. https://doi.org/0.1097/PRS.0000000000008122

 

  1. Saaiq M, 2021, Presentation and outcome of carpal tunnel syndrome with mini incision open carpal tunnel release. Med J Islam Repub Iran, 35: 67. https://doi.org/10.47176/mjiri.35.67

 

  1. Tran TA, Williams LM, Bui D, et al., 2018, Pre-and Post-surgery assessment of carpal tunnel syndrome (CTS) patients: A prospective pilot study comparing CTSAQ and Neuro-QOL for self-assessment outcomes and characterizing median nerve cross sectional area with high resolution ultrasound. J Hand Surg Am, 43: 184e1–e9. https://doi.org/10.1016/j.jhsa.2017.08.015

 

  1. Pace V, Marzano F, Placella G, 2023, Update on surgical procedures for carpal tunnel syndrome: What is the current evidence and practice? What are the future research directions? World J Orthop, 14: 6–12. https://doi.org/10.5312/wjo.v14.i1.6
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Global Translational Medicine, Electronic ISSN: 2811-0021 Print ISSN: 3060-8600, Published by AccScience Publishing
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