Impact of smoking and preoperative electrophysiology on outcome after open carpal tunnel release

Abstract

Background: The aim was to evaluate the influence of smoking and preoperative electrophysiology on the outcome of open carpal tunnel release.

Methods: This retrospective observational study evaluated the outcome in 493 patients (531 hands) primary operated for carpal tunnel syndrome. Data were collected from medical records, health evaluations, and QuickDASH questionnaires before surgery and 1 year after.

Results: Smokers had a higher QuickDASH score preoperatively as well as postoperatively, but the change in total score did not differ. The odds of having a postoperative QuickDASH score >10 were 2.5 times higher in smoking patients than in non-smoking patients. In 124/493 patients (25%), no clinically significant improvement was seen. Normal and extreme preoperative electrophysiology values were associated with higher postoperative scores. No correlation was found between preoperative QuickDASH scores and preoperative electrophysiology values.

Conclusions: Smokers with carpal tunnel syndrome experience more symptoms preoperatively. Smokers have remaining symptoms after surgery. There is no correlation between preoperative QuickDASH scores and preoperative electrophysiology values. Patients with normal or near to normal preoperative electrophysiology results have limited improvement after surgery.

Keywords:

• Carpal tunnel syndrome
• carpal tunnel release
• smoking
• electrophysiology

Acknowledgements

The project was supported by grants from the Swedish Research Council (Medicine), Stiftelsen Svenska Diabetesförbundets forskningsfond, Diabetesföreningen Malmö med omnejd, Swedish Society for Medicine, Lund University, Region Skåne and funds from the Skåne University Hospital Malmö, Sweden. We would like to thank professor Jonas Björk for his excellent statistical advice and Tina Folker and Helen Wilhelmsson for all their administrative help.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Funding

Supported by grants from the Swedish Research Council (Medicine), Svenska Diabetesförbundet, Diabetesföreningen Malmö, Stiftelsen Sigurd och Elsa Goljes Minne, Region Skåne, Lund University and Funds from the Skåne University Hospital Malmö-Lund, Sweden.