A comparison of the results of carpal tunnel release in patients in different age groups

Żyluk, Andrzej; Puchalski, Piotr

doi:10.5114/ninp.2013.35486

Cited by 14 publications

(16 citation statements)

References 20 publications

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“…All patients showed significant improvement in sensation and increases in grip and pinch strengths. However, patients older than 60 had less improvement in total grip strength of the hand [5]. The results of other studies are consistent with these findings [6][7][8].…”

Section: Patient Age At the Operationsupporting

confidence: 81%

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Factors Affecting the Outcomes of Carpal Tunnel Surgery: A Review

Zyluk-Gadowska

Żyluk

2016

Handchir Mikrochir plast Chir

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Ziel der vorliegenden Arbeit war es, unter Berücksichtigung der in Pubmed und Medline veröffentlichten Ergebnisse nach Eingriffen am Karpalkanal zu ermitteln, inwieweit ausgewählte Faktoren wie das Patientenalter, die Dauer der Symptome, die Ausprägung der klinischen und elektrophysiologischen Befunde, das Vorliegen von Begleiterkrankungen und medikolegale Momente die Ergebnisse beeinflussen. Letztlich konnte für keinen der zahlreichen untersuchten Faktoren ein signifikanter Einfluss auf das Langzeitergebnis nachgewiesen werden. Bestehen die Beschwerden länger, sind die klinischen und elektrophysiologischen Befunde ausgeprägter und liegen Begleiterkrankungen vor, so fallen die Ergebnisse weniger gut aus, was darauf hindeutet, dass die betroffenen Patienten etwas weniger von der Operation profitieren. Nur bei Vorliegen von medikolegalen Faktoren wie Rechtsstreit oder Schadenersatzansprüchen lässt sich definitiv ein schlechtes Ergebnis voraussagen.

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Section: Patient Age At the Operationsupporting

confidence: 81%

“…8 articles were reviewed to analyse possible effect of this variable on outcomes [1][2][3][4][5][6][7][8]. In general, older age is associated with poorer rather than better results of any surgical intervention within the hand.…”

Section: Patient Age At the Operationmentioning

confidence: 99%

Factors Affecting the Outcomes of Carpal Tunnel Surgery: A Review

Zyluk-Gadowska

Żyluk

2016

Handchir Mikrochir plast Chir

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“…These findings indica-te the importance of this single parameter as a determinant of the severity of the syndrome and its clinical profile. It also confirms the reliability of choice of the Levine questionnaire as a primary outcome measure in carpal tunnel syndrome [3,[7][8][9][10].…”

Section: Discussionsupporting

confidence: 67%

Factors involved in the clinical profile of carpal tunnel syndrome

Puchalski

Zyluk

Szlosser

et al. 2018

Handchir Mikrochir plast Chir

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Of all the considered variables, the Levine symptom scores had the greatest impact on the condition's clinical profile: the higher scores the more severe pain, poorer sensation, weaker grip and worse hand function. Also, ages greater than 80 years had a significant negative effect on most of the considered parameters. None of the remaining analysed variables had a substantial impact on the clinical profile of the condition.

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“…It must be noted that there is certainly still evidence of benefit for surgical decompression in elderly patients with carpal tunnel syndrome [2][3][4][5]. However, the findings that the extent of nerve damage in these patients may be more extensive, as shown by the nerve conduction study findings, suggest that additional caution may be needed in the risk-benefit analysis when considering surgery in these individuals [10].…”

Section: Introductionmentioning

confidence: 72%

“…Guidelines suggest initially trialling wrist splints, but surgical decompression is often considered for patients with insufficient symptom relief [1]. There are divided opinions regarding the impact of age on the efficacy of surgical decompression [2,3], but increasing evidence is mounting that older patients may have a less satisfactory outcome, though may still benefit from a release [4,5]. At the time of initial publishing, the article by Povlsen 'High incidence of absent nerve conduction in older patients with bilateral carpal tunnel syndrome' [6] was, to our knowledge, the first to suggest an explanation based on human patient data.…”

Section: Introductionmentioning

confidence: 99%

Treating Carpal Tunnel Syndrome in the Elderly: Too little Too Late?

Povlsen¹

2017

Int J Neurorehabilitation Eng

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Carpal tunnel syndrome is the most common peripheral neuropathy presenting to specialist hand and wrist clinics. Surgical decompression of the carpal tunnel considered if non-surgical options have failed. Surgical outcomes may be impaired if damage to the peripheral nerve damage is extensive. Despite conflicting evidence, there is mounting evidence that surgical outcomes for carpal tunnel syndrome are worse in more elderly populations. Indeed, it was found that 50% of patients with bilateral carpal tunnel syndrome aged over 60 have completely absent sensory nerve conduction. More extensive nerve damage in older patient groups may be due to delayed presentation following reduced pain sensitivity with age, reductions in nerve conduction velocities with the normal aging process and reduced axonal regeneration capacity with aging. Whilst more research is required, these findings should influence consenting information given to patients considered for surgery.

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A comparison of the results of carpal tunnel release in patients in different age groups

Abstract: Patients with carpal tunnel syndrome at any age may expect a similar benefit from surgery.

Cited by 14 publications

References 20 publications

Factors Affecting the Outcomes of Carpal Tunnel Surgery: A Review

Factors Affecting the Outcomes of Carpal Tunnel Surgery: A Review

Factors involved in the clinical profile of carpal tunnel syndrome

Treating Carpal Tunnel Syndrome in the Elderly: Too little Too Late?

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