Affiliation:
1. Department of General Surgery and Transplantation, Pomeranian Medical University in Szczecin, Poland
2. Klinik fur Innere Medizin. Gastroenterologie, Nephrologie, Haematologie und Onkologie. Asklepios Klinikum Uckermark, Schwedt, Germany
3. Department of Hand Surgery and Reconstructive Microsurgery
Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy
Abstract
<b><br>Introduction:</b> The results of some studies show that predictors of less favourable outcomes of surgery for carpal tunnel syndrome might include the presence of comorbidities, such as diabetes and thyroid gland diseases. The role of these factors has not been clearly determined, but in most trials the patients burdened with comorbidities conducive to CTS are excluded from the analysis.</br> <b><br>Aim:</b> The aim of this study was to investigate the effect of concomitant diseases on the clinical profile and outcomes of surgery for carpal tunnel syndrome.</br> <b><br>Material and methods:</b> The study group consisted of 1117 patients – 909 women (81%) and 208 men (19%) – at a mean age of 63 years. A total of 972 patients (87%) declared having at least one comorbidity, whereas 145 patients (13%) declared no comorbidities. The measurements were performed preoperatively and at 6 months postoperatively; they included pain intensity, total grip and key-pinch strength, digital sensibility and hand function with Levine’s questionnaire.</br> <b><br>Results:</b> At baseline, the patients with comorbidities had significantly worse digital sensiblility, weaker total grip strength and greater functional impairment of the hand, but only grip strength reached the minimal important difference (3.5 kg). Carpal tunnel release resulted in significant improvement in the tested variables for all patients, although the outcomes at 6 months were less favourable for those with comorbidities with regard to digital sensiblility, total grip and pinch strength and function of the hand. All these differences were statistically significant, but only grip strength reached the minimal important difference (2.9 kg).</br> <b><br>Conclusion:</b> The results of this study show that comorbidities in patients suffering from CTS had a statistically and clinically significant negative effect only on the total grip strength pre- and postoperatively, and no significant effect on the outcome of surgery, which was satisfactory in all patients.</br>