Clinical and Electrophysiological Outcomes of Carpal Tunnel Release Surgery:

Ali Abbas Hashim Almusawi; Fizel Alhimyari; Ali Salman Jasim  Almamoori; Aumaima Tariq Abed; Hayder Abdul-Amir Al-Hindy

doi:10.54133/ajms.v11i2.3137

Authors

Ali Abbas Hashim Almusawi Hammurabi College of Medicine, University of Babylon, Babylon, Iraq https://orcid.org/0000-0002-1520-7982
Fizel Alhimyari Hammurabi College of Medicine, University of Babylon, Babylon, Iraq
Ali Salman Jasim Almamoori College of Dentistry, University of Al-Mustaqbal, Babylon, Iraq
Aumaima Tariq Abed Department of Pharmacy, Al-Zahrawy University College, Kerbala, Iraq https://orcid.org/0009-0008-5604-6792
Hayder Abdul-Amir Al-Hindy Department of Pharmacology and Toxicology, College of Pharmacy, University of Babylon, Babylon, Iraq https://orcid.org/0000-0001-6232-8501

DOI:

https://doi.org/10.54133/ajms.v11i2.3137

Keywords:

Carpal tunnel syndrome, Electrophysiology, Motor nerve, NCS, Sensory nerve

Abstract

Background: Carpal Tunnel Syndrome (CTS) is the most prevalent entrapment neuropathy that often requires surgical intervention in severe cases. Objective: To evaluate the clinical and electrophysiological outcomes of carpal tunnel release surgery. Methods: In this retrospective cohort study, 102 hands of 84 patients, who underwent carpal tunnel release (CTR) for CTS, were included. Patients were stratified into three groups (mild, moderate, and severe) based on symptom presentation and preoperative nerve conduction studies (NCS). NCS findings further categorized median nerve dysfunction into five electrodiagnostic grades (mild to severe). All patients received division of the flexor retinaculum without adjunctive neurolysis. Postoperative clinical and electrophysiological reassessments were performed at a mean follow‑up of 14 months to assess recovery. Results: Baseline severity was correlated negatively with recovery. Patients with mild disease (100%) were completely clinically and electrophysiologically normal, whereas 11 (91.7%) with moderate disease had significant improvement, with one patient remaining with residual weakness, and 5 of 7 patients with severe disease improved, with 2 patients having persistent motor deficits at a mean postoperative follow-up of 14 months (41.6%). Intraoperative findings revealed 9 pseudoneuromas (28.1%), 7 cases of abnormal muscle anatomy, 6 cases of Colles' fracture malunion, 7 cases of diabetes/hypothyroidism, 2 cases of rheumatoid arthritis, and 44% of idiopathic cases. Conclusions: Older patients should receive early treatment when NCS is crucial, for both proper diagnosis and therapeutic planning. Standard flexor retinaculum release provides effective treatment for most of the population; however, severe cases might require additional therapeutic methods.

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