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Splinting after Carpal Tunnel Release: Current Practice, Scientific Evidence, and Trends

Henry, Steven L. M.D.; Hubbard, Bradley A. M.D.; Concannon, Matthew J. M.D.

Plastic and Reconstructive Surgery: October 2008 - Volume 122 - Issue 4 - p 1095-1099
doi: 10.1097/PRS.0b013e31818459f4
Hand/Peripheral Nerve: Original Articles

Background: Postoperative splinting is common after carpal tunnel release, despite a lack of scientific evidence supporting its value. The purpose of this study was to characterize postoperative splinting regimens among hand surgeons and to identify trends in splint use after this procedure.

Methods: Questionnaires were mailed to members of the American Society for Surgery of the Hand. Recipients were asked to record whether and for how long they use splints after carpal tunnel release. They were also asked to indicate their training (i.e., orthopedic, plastic, or general surgery). Results were compared with those of previously conducted surveys.

Results: One thousand ninety-one questionnaires were returned, for a response rate of 48 percent. Fifty-three percent of respondents use splinting postoperatively. Duration of splinting varied tremendously, from 1 to 42 days. Splinting patterns were similar across all training backgrounds. In comparison with related surveys conducted in 1987 and 1997, a trend is evident toward less use of splinting after carpal tunnel release.

Conclusions: The use and duration of splinting after carpal tunnel release vary widely among hand surgeons. This divergence of practice implies that there is little therapeutic benefit to splinting after this procedure, a concept supported by substantial scientific evidence and by a trend away from splinting over the past 20 years.

San Antonio, Texas; and Columbia, Mo.

From The Hand Center of San Antonio; the Division of Plastic Surgery, University of Missouri–Columbia; and private practice.

Received for publication January 1, 2008; accepted February 27, 2008.

Presented at the 40th Annual Scientific Meeting of the Missouri Chapter of the American College of Surgeons, in Lake of the Ozarks, Missouri, June 15, 2007.

Disclosure: The authors have no financial interest or commercial association with any of the subject matter mentioned in this article.

Steven L. Henry, M.D.; The Hand Center of San Antonio; 21 Spurs Lane, Suite 310; San Antonio, Texas 78240;

©2008American Society of Plastic Surgeons