Plastic & Reconstructive Surgery:
Splinting after Carpal Tunnel Release: Current Practice, Scientific Evidence, and Trends
Ünlü, Ramazan E.; Altun, Serdar M.D.; İnözü, Emre M.D.; Arpac, Enver M.D.ı
Plastic and Reconstructive Surgery, Ankara Numune Hospital; Ankara, Turkey (Ünlü, Altun, İnözü, Arpacı)
Correspondence to Dr. Altun; Plastic and Reconstructive Surgery; Ankara Numune Hospital; Ata Mahallesi; 2. Cadde, 176. Sokak; 6/15, Öveçler; Ankara 06460, Turkey
We read with great interest the article by Henry et al. entitled “Splinting after Carpal Tunnel Release: Current Practice, Scientific Evidence, and Trends” (Plast Reconstr Surg. 2008;122:1095–1099) and were pleased to see this good article addressing this important issue.
As mentioned in the article, there is wide variability in the use and duration of postoperative splinting after carpal tunnel release. The authors decided that no scientific evidence existed to support the use of splints after carpal tunnel release.
We have over 500 cases and 10 years of clinical experience in carpal tunnel release surgery. We think proper splinting with short duration is important for both wound healing and reduction of edema formation1,2; splinting is a part of hand rehabilitation. Early postoperative static splinting that is applied for a short time provides support, maintains position, and reduces pain during the healing process.
The use of a dorsal splint for the first 3 days after surgery is a helpful measure and prevents the median nerve from prolapsing forward and becoming adherent to or trapped by the edges of the severed transverse carpal ligament.3 Thus, it is hard to say that postoperative splinting after carpal tunnel release is of no benefit.
We agree that long-duration splinting may cause some problems, especially in older patients. However, this does not totally eliminate the necessary use of splinting.
We conclude that the best policy would be short-term postoperative splinting followed by early active motion.
Ramazan E. Ünlü
Serdar Altun, M.D.
Emre İnözü, M.D.
Enver Arpacı, M.D.
Plastic and Reconstructive Surgery, Ankara Numune Hospital
1. Sailer SM. The role of splinting and rehabilitation in the treatment of carpal and cubital tunnel syndromes. Hand Clin. 1996;12:223–241.
2. Nobuta S, Sato K, Nagakawa T, Hatori M, Itoi E. Effects of wrist splinting for Carpal Tunnel syndrome and motor nerve conduction measurements. Ups J Med Sci. 2008;113:181–192.
3. Laws ER Jr. Referral guidelines: Carpal tunnel syndrome. Neurosurg Focus 1997;15:e11.
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