Skip to main content
Top
Published in: European Journal of Orthopaedic Surgery & Traumatology 7/2014

01-10-2014 | Original Article

Carpal tunnel release in patients with diabetes result in poorer outcome in long-term study

Authors: Deniz Gulabi, Gultekin Cecen, Bulent Guclu, Aycicek Cecen

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 7/2014

Login to get access

Abstract

Background

The aim of this prospective study was to compare the results of surgical decompression of carpal tunnel syndrome (CTS) in patients with diabetes mellitus with those with idiopathic CTS.

Methods

The results of surgical decompression of CTS in 27 patients with diabetes mellitus were compared with 42 patients with idiopathic CTS. All patients underwent surgical release of transverse carpal ligament by the mini-incision of palm technique. Patient self-administered Boston Questionnaire (BQ) for the assessment of severity of CTS symptoms and hand functional status was evaluated before and 6 months and 10 years after surgery.

Results

After surgical release, all the patients of both groups reported an absence of pain, disappearance or reduction of paresthesia, and improvement in hand function. Six months after surgery, there was a significant improvement of symptomatic and functional BQ scores compared with preoperative state in both groups. Ten years after surgery, there was statistical difference in preoperative and postoperative 10th year functional BQ score between DM (−) and DM (+) (p < 0.01). DM status affected statistically functional BQ score between preoperative and postoperative 10th year.

Conclusion

Diabetes mellitus was a risk factor for poor outcome of surgical decompression of CTS. Patients with diabetes had worse surgical outcome compared with patients with idiopathic CTS in long-term follow-up.
Literature
1.
go back to reference Jablecki CK, Andary MT, So YT, Wilkins DE, Williams FH (1993) Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome—AAEM Quality Assurance Committee. Muscle Nerve 16:1392–1414PubMedCrossRef Jablecki CK, Andary MT, So YT, Wilkins DE, Williams FH (1993) Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome—AAEM Quality Assurance Committee. Muscle Nerve 16:1392–1414PubMedCrossRef
2.
go back to reference Akhtar S, Sinha S, Bradley MJ, Burke FD, Wilgis SE, Dubin NH (2007) Study to assess differences in outcome following open carpal tunnel decompressions performed by surgeons of differing grade. Ann R Coll Surg Engl 89:785–788PubMedCentralPubMedCrossRef Akhtar S, Sinha S, Bradley MJ, Burke FD, Wilgis SE, Dubin NH (2007) Study to assess differences in outcome following open carpal tunnel decompressions performed by surgeons of differing grade. Ann R Coll Surg Engl 89:785–788PubMedCentralPubMedCrossRef
3.
go back to reference Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I (1999) Prevalence of carpal tunnel syndrome in a general population. JAMA 282:153–158PubMedCrossRef Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I (1999) Prevalence of carpal tunnel syndrome in a general population. JAMA 282:153–158PubMedCrossRef
4.
go back to reference de Krom MC, Knipschild PG, Kester AD, Thijs CT, Boekkooi PF, Spaans F (1992) Carpal tunnel syndrome: prevalence in the general population. J Clin Epidemiol 45:373–376PubMedCrossRef de Krom MC, Knipschild PG, Kester AD, Thijs CT, Boekkooi PF, Spaans F (1992) Carpal tunnel syndrome: prevalence in the general population. J Clin Epidemiol 45:373–376PubMedCrossRef
5.
go back to reference Dyck PJ, Kratz KM, Karnes JL et al (1993) The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort—the Rochester Diabetic Neuropathy Study. Neurology 43:817–824PubMedCrossRef Dyck PJ, Kratz KM, Karnes JL et al (1993) The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort—the Rochester Diabetic Neuropathy Study. Neurology 43:817–824PubMedCrossRef
6.
go back to reference Haupt WF, Wintzer G, Schop A, Löttgen J, Pawlik G (1993) Long-term results of carpal tunnel decompression. Assessment of 60 cases. J Hand Surg Br 18:471–484PubMedCrossRef Haupt WF, Wintzer G, Schop A, Löttgen J, Pawlik G (1993) Long-term results of carpal tunnel decompression. Assessment of 60 cases. J Hand Surg Br 18:471–484PubMedCrossRef
7.
go back to reference Albers JW, Brown MB, Sima AA, Greene DA (1996) Frequency of median mononeuropathy in patients with mild diabetic neuropathy in the early diabetes intervention trial (EDIT)—Tolrestat Study Group for edit (Early Diabetes Intervention Trial). Muscle Nevre 19:1504–1505 Albers JW, Brown MB, Sima AA, Greene DA (1996) Frequency of median mononeuropathy in patients with mild diabetic neuropathy in the early diabetes intervention trial (EDIT)—Tolrestat Study Group for edit (Early Diabetes Intervention Trial). Muscle Nevre 19:1504–1505
8.
go back to reference Celiker R, Basgoze O, Bayraktar M (1996) Early detection of neurological involvement in diabetes mellitus. Electromyogr Clin Neurophysiol 36:29–35PubMed Celiker R, Basgoze O, Bayraktar M (1996) Early detection of neurological involvement in diabetes mellitus. Electromyogr Clin Neurophysiol 36:29–35PubMed
9.
go back to reference Johnson EW (1993) Sixteenth annual AAEM Edward H. Lambert Lecture. Electrodiagnostic aspects of diabetic neuropathies: entrapments—American Association of Electrodiagnostic Medicine. Muscle Nerve 16:127–134PubMedCrossRef Johnson EW (1993) Sixteenth annual AAEM Edward H. Lambert Lecture. Electrodiagnostic aspects of diabetic neuropathies: entrapments—American Association of Electrodiagnostic Medicine. Muscle Nerve 16:127–134PubMedCrossRef
10.
go back to reference Sidenius P, Jakobsen J (1979) Axonal transport in early experimental diabetes. Brain Res 173:315–330PubMedCrossRef Sidenius P, Jakobsen J (1979) Axonal transport in early experimental diabetes. Brain Res 173:315–330PubMedCrossRef
11.
go back to reference Tomlinson DR, Mayer JH (1984) Defects of axonal transport in diabetes mellitus: a possible contribution to the aetiology of diabetic neuropathy. J Auton Pharmacol 4:59–72PubMedCrossRef Tomlinson DR, Mayer JH (1984) Defects of axonal transport in diabetes mellitus: a possible contribution to the aetiology of diabetic neuropathy. J Auton Pharmacol 4:59–72PubMedCrossRef
12.
go back to reference Lewis C, Mauffrey C, Newman S, Lambert A, Hull P (2010) Current concepts in carpal tunnel syndrome: a review of the literature. Eur J Orthop Surg Traumatol 20:445–452CrossRef Lewis C, Mauffrey C, Newman S, Lambert A, Hull P (2010) Current concepts in carpal tunnel syndrome: a review of the literature. Eur J Orthop Surg Traumatol 20:445–452CrossRef
13.
go back to reference Jenkins PJ, Duckworth AD, Watts AC, McEachan JE (2012) The outcome of carpal tunnel decompression in patients with diabetes mellitus. J Bone Jt Surg Br 94:811–814CrossRef Jenkins PJ, Duckworth AD, Watts AC, McEachan JE (2012) The outcome of carpal tunnel decompression in patients with diabetes mellitus. J Bone Jt Surg Br 94:811–814CrossRef
14.
go back to reference Mondelli M, Padua L, Reale F, Signorini AM, Romano C (2004) Outcome of surgical release among diabetics with carpal tunnel syndrome. Arch Phys Med Rehabil 85:7–13PubMedCrossRef Mondelli M, Padua L, Reale F, Signorini AM, Romano C (2004) Outcome of surgical release among diabetics with carpal tunnel syndrome. Arch Phys Med Rehabil 85:7–13PubMedCrossRef
15.
go back to reference Ozkul Y, Sabuncu T, Kocabey Y, Nazligul Y (2002) Outcomes of carpal tunnel release in diabetic and non-diabetic patients. Acta Neurol Scand 106:168–172PubMedCrossRef Ozkul Y, Sabuncu T, Kocabey Y, Nazligul Y (2002) Outcomes of carpal tunnel release in diabetic and non-diabetic patients. Acta Neurol Scand 106:168–172PubMedCrossRef
16.
go back to reference Thomsen NO, Cederlund R, Rosén I, Björk J, Dahlin LB (2009) Clinical outcomes of surgical release among diabetic patients with carpal tunnel syndrome: prospective follow-up with matched controls. J Hand Surg Am 34:1177–1187PubMedCrossRef Thomsen NO, Cederlund R, Rosén I, Björk J, Dahlin LB (2009) Clinical outcomes of surgical release among diabetic patients with carpal tunnel syndrome: prospective follow-up with matched controls. J Hand Surg Am 34:1177–1187PubMedCrossRef
17.
go back to reference Zyluk A, Puchalski P (2013) A comparison of outcomes of carpal tunnel release in diabetic and non-diabetic patients. J Hand Surg Eur 38:485–488CrossRef Zyluk A, Puchalski P (2013) A comparison of outcomes of carpal tunnel release in diabetic and non-diabetic patients. J Hand Surg Eur 38:485–488CrossRef
Metadata
Title
Carpal tunnel release in patients with diabetes result in poorer outcome in long-term study
Authors
Deniz Gulabi
Gultekin Cecen
Bulent Guclu
Aycicek Cecen
Publication date
01-10-2014
Publisher
Springer Paris
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue 7/2014
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-014-1418-z

Other articles of this Issue 7/2014

European Journal of Orthopaedic Surgery & Traumatology 7/2014 Go to the issue