Ellingwood Ashley A, Nwakibu Uzoma, Sternberg Maya, Ugwonali Obinwanne
Peachtree Orthopedics, Atlanta, GA.
Wellstar Kennestone Regional Medical Center, Marietta, GA.
J Hand Surg Glob Online. 2025 Jun 19;7(5):100774. doi: 10.1016/j.jhsg.2025.100774. eCollection 2025 Sep.
The purpose of this study was to investigate the relationship between previous trauma to upper extremities and the subsequent development of carpal tunnel syndrome (CTS). By comparing cases of traumatically induced CTS with idiopathic CTS, the study aims to evaluate differences in symptom severity and postsurgical treatment outcomes. Additionally, the study explores other factors associated with higher pain scores and longer lengths of care.
A retrospective study was conducted on patients who underwent carpal tunnel release surgery by a single hand surgeon from January 1, 2014 to October 1, 2020. Pre- and postoperative care duration and pain levels, assessed using a visual analog scale, were the primary outcomes. To analyze the predictors of pain levels and recovery time, unadjusted means were generated, followed by the development of a model to account for potential correlations and contributions.
The study included 478 patients (324 women and 154 men) with a mean age of 53.2 years, all of whom underwent carpal tunnel release surgery. Patients with traumatic injuries had higher initial and final pain scores compared with those with nontraumatic causes. Notably, trauma was not a significant factor in the length of care model, despite its association with pain scores. Meanwhile, worker's compensation was a factor associated with prolonged length of care.
This study demonstrates that traumatic injuries and other factors, such as worker's compensation, gender, and race/ethnicity, significantly influence both pain levels and length of care in patients undergoing carpal tunnel release surgery. These findings emphasize that CTS can develop after trauma and is not exclusively idiopathic. Addressing various clinical and socioeconomic factors is essential for enhancing treatment effectiveness and managing expectations following surgery.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapy/Prevention, Etiology/Harm; IV.
本研究旨在调查上肢既往创伤与随后腕管综合征(CTS)发生之间的关系。通过比较创伤性CTS病例与特发性CTS病例,该研究旨在评估症状严重程度和术后治疗结果的差异。此外,该研究还探索了与较高疼痛评分和较长护理时长相关的其他因素。
对2014年1月1日至2020年10月1日由同一位手外科医生进行腕管松解手术的患者进行了一项回顾性研究。使用视觉模拟量表评估的术前和术后护理时长及疼痛程度是主要结果。为了分析疼痛程度和恢复时间的预测因素,先得出未调整的均值,然后建立一个模型以考虑潜在的相关性和影响因素。
该研究纳入了478例患者(324名女性和154名男性),平均年龄为53.2岁,所有患者均接受了腕管松解手术。与非创伤性病因患者相比,创伤性损伤患者的初始和最终疼痛评分更高。值得注意的是,尽管创伤与疼痛评分相关,但在护理时长模型中它并不是一个显著因素。同时,工伤赔偿是与护理时长延长相关的一个因素。
本研究表明,创伤性损伤以及工伤赔偿、性别和种族/族裔等其他因素,对接受腕管松解手术患者的疼痛程度和护理时长均有显著影响。这些发现强调CTS可在创伤后发生,并非完全是特发性的。解决各种临床和社会经济因素对于提高治疗效果和管理术后预期至关重要。
研究类型/证据水平:治疗/预防、病因学/危害;IV级