Avisar Erez, Assaraf Eran, Essa Ahmad, Zuo Kevin, Lindner Dror, Persitz Jonathan
Hand and Upper Extremity Surgery Unit, Department of Orthopaedic Surgery, Yitzhak Shamir Medical Center, Tzrifin, ISR.
Department of Orthopaedic Surgery, Yitzhak Shamir Medical Center, Tzrifin, ISR.
Cureus. 2025 May 6;17(5):e83615. doi: 10.7759/cureus.83615. eCollection 2025 May.
The purpose of this prospective study was to evaluate the influence of perioperative glycemic control, as detected by glycosylated hemoglobin (HbA1c) levels, on clinical outcomes after open carpal tunnel release (CTR) surgery.
The demographic and clinical data of the study participants were prospectively collected prior to surgery and at one year postoperatively. Objective evaluations included grip and pinch strength, along with sensation testing over the index finger using Semmes-Weinstein monofilaments (SWMF). Subjective assessments, including pain intensity (measured by the visual analog scale (VAS)), the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and the Mayo Wrist Score, were also recorded.
The study included 50 patients, comprising 27 with type 2 diabetes mellitus (mean HbA1c: 7.49 ± 1.42) and 23 without diabetes. HbA1c levels were measured up to one month prior to surgery. No statistically significant differences were found in grip strength, pinch strength, or Semmes-Weinstein monofilament (SWMF) values pre- and postoperatively in both diabetic and non-diabetic groups. Pain intensity decreased in both groups at 12 months postoperatively, but the degree of pain improvement was not statistically different between groups. Both groups showed postoperative improvement in DASH and Mayo Wrist Scores, with no significant difference in the level of improvement between the groups. Pearson analysis showed no correlation between objective and subjective measures pre- and postoperatively and HbA1c levels.
Elevation of perioperative HbA1c levels in diabetic patients did not negatively affect surgical outcomes compared to non-diabetic patients. Both groups demonstrated significant functional improvements, with no notable differences in recovery or postoperative hand function.
本前瞻性研究旨在评估糖化血红蛋白（HbA1c）水平所检测的围手术期血糖控制对开放性腕管松解术（CTR）术后临床结局的影响。
前瞻性收集研究参与者术前及术后一年的人口统计学和临床数据。客观评估包括握力和捏力，以及使用Semmes-Weinstein单丝（SWMF）对示指进行感觉测试。还记录了主观评估，包括疼痛强度（通过视觉模拟量表（VAS）测量）、手臂、肩部和手部功能障碍（DASH）问卷以及梅奥腕关节评分。
该研究纳入50例患者，其中27例为2型糖尿病患者（平均HbA1c：7.49±1.42），23例无糖尿病。在手术前一个月内测量HbA1c水平。糖尿病组和非糖尿病组术前和术后的握力、捏力或Semmes-Weinstein单丝（SWMF）值均未发现统计学上的显著差异。两组术后12个月疼痛强度均降低，但两组间疼痛改善程度无统计学差异。两组术后DASH和梅奥腕关节评分均有所改善，两组间改善水平无显著差异。Pearson分析显示术前和术后客观和主观测量与HbA1c水平之间无相关性。
与非糖尿病患者相比，糖尿病患者围手术期HbA1c水平升高并未对手术结局产生负面影响。两组均显示出显著的功能改善，恢复情况或术后手部功能无明显差异。
