MANAGEMENT OF CARPAL TUNNEL SYNDROME

AN EXPERIENCE IN DHQ TEACHING HOSPITAL D.I. KHAN, PAKISTAN

Abstract

BACKGROUND: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, which is clear from the fact that approximately 250,000 to 300,000 carpal tunnel releases are performed annually in the United States. The incidence of CTS is estimated to be approximately 1% for the general population and about 5% or more for workers, who worked in industries that demand repetitive use of the hands and wrists .Objective of this study was to collect data on clinical characteristics and outcomes of carpal tunnel syndrome. 
METHODS: This prospective observational study was conducted in Neurosurgery department of DHQ Hospital, Gomal Medical College D. I. Khan, from April 2015 to March 2016. All the diagnosed patients of either age and sex were included in the study, while patients with associated cervical pathology were excluded from the study. Initially patients were treated conservatively. Patients failing to conservative treatment were offered surgery. The follow up was done at 1 month and 2 months post-operatively. A database was compiled using medical records. Data collection included variables, such as age, sex,side of involvement, disease severity and improvement in symptoms at follow-up visits. 
RESULTS:: Majority of the patients, 45 (78.9%), were female. The age ranges from 20-95 years, with mean age of 39.79± 11.25 years. Right hand was involved in most of the patients, 33 (57.9%). The disease was mild in 11 (19.3%), moderate in 29 (50.9) and severe in 17 (29.8%) patients. After 1 month of conservative treatment, 24 (42.1%) patients were improved, while remaining patients underwent surgical decompression, carpal tunnel release. At final follow-up, out of 33 patients, 29 (90.6%) were improved, while in 3 patients there was re-occurrence of CTS and in those re-surgery was done. 
CONCLUSION: Carpal tunnel syndrome is common in females, age group of 36-50 years with dominancy of right hand involvement. Conservative treatment has a role in mild to moderate disease, but surgery plays a vital role in severe cases and patients refractory to conservative treatment. 
KEY WORDS: Carpal Tunnel Syndrome, Outcome, Carpal Tunnel Release.