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Staged versus Simultaneous Bilateral Endoscopic Carpal Tunnel Release: An Outcome Study

Nesbitt, Kristin S. M.D.; Innis, Peter C. M.D.; Dubin, Norman H. Ph.D.; Wilgis, E F. Shaw M.D.

Plastic and Reconstructive Surgery: July 2006 - Volume 118 - Issue 1 - p 139-145
doi: 10.1097/01.prs.0000221073.99662.39

Background: This study compared outcomes of bilateral simultaneous endoscopic carpal tunnel release to staged release using the Levine-Katz outcome instrument and physical measurements.

Methods: Seventy-one patients were evaluated preoperatively and at 6 months postoperatively. One group underwent simultaneous releases, a second group underwent staged releases 1 to 3 weeks apart, and a third underwent staged releases more than 3 weeks apart. Preoperative data included age, gender, race, medical history, initial symptom severity score, and body mass index. Preoperative and postoperative data included Semmes-Weinstein testing, grip and pinch strength, Tinel's sign, Phalen's test, Levine-Katz questionnaire, occupational history, postoperative complications, and patient satisfaction.

Results: Groups were similar demographically except that the simultaneous group had more men and patients were younger. Level of preoperative symptom severity was similar in all groups. Physical measurements were similar for all groups preoperatively and improved similarly at follow-up. All groups improved Levine-Katz mean symptom severity score and functional status score at follow-up. The groups had no significant difference in number of complications, and patient satisfaction was similar.

Conclusions: In selected patients, bilateral simultaneous endoscopic carpal tunnel release has an outcome similar to that for surgery staged weeks apart. However, patients who choose simultaneous surgery may benefit from a shorter postoperative disability period and earlier return to work.

Baltimore, Md.

From the Curtis National Hand Center, Union Memorial Hospital.

Received for publication December 1, 2004; revised April 8, 2005.

E. F. Shaw Wilgis, M.D., c/o Anne Rupert Mattson, Editor, Curtis National Hand Center, Union Memorial Hospital, 3333 North Calvert Street, Suite 200, Baltimore, Md. 21218,

©2006American Society of Plastic Surgeons