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
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
3. Laws ER Jr. Referral guidelines: Carpal tunnel syndrome. Neurosurg Focus
Letters to the Editor, discussing material recently published in the Journal, are welcome. They will have the best chance of acceptance if they are received within 8 weeks of an article’s publication. Letters to the Editor may be published with a response from the authors of the article being discussed. Discussions beyond the initial letter and response will not be published. Letters submitted pertaining to published Discussions of articles will not be printed. Letters to the Editor are not usually peer reviewed, but the Journal may invite replies from the authors of the original publication. All Letters are published at the discretion of the Editor.
Authors will be listed in the order in which they appear in the submission. Letters should be submitted electronically via PRS’ enkwell, at www.editorialmanager.com/prs/.
We reserve the right to edit Letters to meet requirements of space and format. Any financial interests relevant to the content of the correspondence must be disclosed. Submission of a Letter constitutes permission for the American Society of Plastic Surgeons and its licensees and asignees to publish it in the Journal and in any other form or medium.
The views, opinions, and conclusions expressed in the Letters to the Editor represent the personal opinions of the individual writers and not those of the publisher, the Editorial Board, or the sponsors of the Journal. Any stated views, opinions, and conclusions do not reflect the policy of any of the sponsoring organizations or of the institutions with which the writer is affiliated, and the publisher, the Editorial Board, and the sponsoring organizations assume no responsibility for the content of such correspondence.