Effectiveness of the Temporary Splinting after Carpal Tunnel Release

Czech version

Authors: A. Fibír ¹; R. Čáp ^2,3; J. Vaněk ⁴
Authors‘ workplace: Oddělení plastické a estetické chirurgie, První privátní chirurgické centrum, s. r. o., SANUS, Hradec Králové ¹; Katedra válečné chirurgie, Fakulta vojenského zdravotnictví UO, Hradec Králové ²; Oddělení plastické chirurgie a léčby popálenin, Chirurgická klinika LF UK a FN Hradec Králové ³; Katedra informatiky a kvantitativních metod, Fakulta informatiky a managementu UHK ⁴
Published in: Cesk Slov Neurol N 2014; 77/110(6): 691-697
Category: Original Paper

Overview

Aim:
Correct post-operative care is an important part of recovery after carpal tunnel decompression. The aim of this prospective randomized study was to determine whether postoperative temporary splinting has a clinically significant effect, or whether it is unnecessary. The results of published data do not give clear, demonstrable and unambiguous recommendations.

Material and methods:
A total of 72 patients with clinically and electrodiagnostically established diagnosis of carpal tunnel syndrome were randomized into two groups. The first group included patients with a dorsal splint, fixing the wrist in a neutral position for two weeks after surgery, whereas the second group included patients, in whom the splint was not used after surgery. Distal motor latency, grip strength and degree of subjective symptoms were assessed before and after surgery using specific questionnaires, namely the DASH questionnaire (Disabilities of Arm, Shoulder and Hand) and the Boston questionnaire (Boston Carpal Tunnel Questionnaire).

Results:
After surgery, there was a reduction of distal motor latency and a moderate reduction of grip strength, but there were no statistically significant differences (p > 0.05) between the two groups. After surgery, the anticipated improvement of subjective symptoms was achieved, objectified by questionnaire coefficients. However, there was no statistically significant difference (p > 0.05) between the two groups either.

Conclusion:
According to our findings, temporary splinting after open carpal tunnel decompression does not improve the results of surgical treatment compared to the non-splinted group. Using the splint in this indication seems to be redundant from the medical and economic point of view. On the other hand, temporary splinting after surgery does not cause worsening of the results of surgical treatment.

Key words:
carpal tunnel syndrome – surgical decompression – immobilisation – splints – postoperative care – electromyography

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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