Carpal tunnel release for advanced disease in patients 70 years and older: does outcome from the patient's perspective justify surgery?

Because more advanced stages of nerve compression are likely to result in intraneural changes including intrinsic fibrosis and axon loss, we hypothesised that carpal tunnel release for advanced carpal tunnel syndrome might not result in satisfactory resolution of symptoms. We were particularly interested in evaluating a population of elderly patients 70 years and older for whom relief of symptoms is the overwhelming objective of surgery. Our retrospective assessment of symptom resolution and patient satisfaction in 13 patients with advanced carpal tunnel syndrome utilized a validated self-administered questionnaire and revealed minimal symptoms in 11 patients. Although carpal tunnel release is unlikely to result in the total elimination of symptoms when performed in elderly patients with advanced disease, outcome from the patient's perspective appears to be satisfactory and the surgery quite justified.