The Outcome of the Un-operated Contralateral Hand in Bilateral Carpal Tunnel Syndrome.

Ahn, Duck Sun; Park, Soo Wan; Yoon, Eul Sik

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2001;28(4):353-356.
Published online July 1, 2001.

The Outcome of the Un-operated Contralateral Hand in Bilateral Carpal Tunnel Syndrome.

Duck Sun Ahn, Soo Wan Park, Eul Sik Yoon

Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea.

Abstract

It is not well known how the un-operated contralateral hand behaves in bilateral carpal tunnel syndrome(CTS). Out of 324 CTS patients, we studied 20 who had carpal tunnel release on one hand only, in order to evaluate the postoperative outcome of the un-operated contralateral hand in bilateral carpal tunnel syndrome. All 324 patients were subject to clinical and electrodiagnostic studies on both hands. This study group was composed of patients who had bilateral CTS, diagnosed clinically and electrophysiologically, but who had surgery done only on the hand with the most pronounced symptoms. The results of the electrodiagnosis were categorized according to the severity of median nerve damage (mild, moderate, severe). The decision for surgery was based on clinical assessment and electrodiagnostic study. The outcome and postoperative clinical course of the un-operated contralateral hand were evaluated by EMG and telephone survey. This method of survey was used because of the patients' residence area spread throughout the country. Within one year, all 20 operated hands showed significant improvement. Regarding progress of the un-operated contralateral hand, 10 patients showed improvement of one grade, while five patients showed three grades of improvements. In five other patients, there was no change whatsoever. The postoperative EMG findings of the un-operated contralateral hand did not commensurate with the symptoms. However, regardless of EMG results, the un-operated contralateral hand showed improvement that was of statistical significance(p < 0.0001).

Keywords: Carpal tunnel syndrome; Un-operated contralateral hand