Postoperative swelling after carpal tunnel release with and without an arm sling : A controlled before-and-after study on the effect of wearing an arm sling on postoperative recovery after carpal tunnel release

Kroeze, M.J.A.M. (2016) Postoperative swelling after carpal tunnel release with and without an arm sling : A controlled before-and-after study on the effect of wearing an arm sling on postoperative recovery after carpal tunnel release. thesis, Medicine.

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Abstract

BACKGROUND – Carpal tunnel syndrome (CTS) is the most commonly diagnosed entrapment neuropathy, for which carpal tunnel release (CTR) is the surgical treatment. There are no national guidelines defining standard care after CTR and an arm sling may be used depending on local policy. There is no conclusive evidence that elevation is useful after minor hand surgery. We therefore aimed to investigate the effect of wearing an arm sling on postoperative recovery after CTR. The primary outcome was postoperative swelling. Secondary outcomes were postoperative pain, stiffness and mobility, and CTS symptoms. METHODS – A single-centre controlled before-and-after trial was conducted at the department of Plastic Surgery. Patients undergoing standard open CTR were included in the sling group from September 29th to November 8th and in the non-sling group from November 9th to December 18th 2015. Participants were evaluated preoperatively and three to four days postoperatively. Follow-up for CTS symptoms was six weeks. Postoperative outcomes were compared between both groups. RESULTS – Thirty-four patients were included in the sling group versus 31 in the non-sling group. Median postoperative swelling was respectively 20.7 ml (4.1%) versus 15.3 ml (3.5%) (p = 0.302). Overall pain scores were the same across both groups, but lower in the sling group 12 hours after CTR (p = 0.026). Pulp-to-palm distance (PPD), a measure of overall flexion, was the same for both groups (p = 0.268), as were the symptom severity score (SSS) and functional status score (FSS) on the Boston carpal tunnel questionnaire (respectively, p = 0.641 and p = 0.358). CONCLUSION – Postoperative care without use of an arm sling after CTR does not affect postoperative recovery or outcomes of surgery. These findings do not support the routine use of a standard arm sling after CTR.

Item Type:	Thesis (Thesis)
Supervisor name:	Supervisor: and Houpt, Dr. P. and Plastic Surgeon and Department of Plastic Surgery and Isala Clinics Zwolle
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:56
Last Modified:	25 Jun 2020 10:56
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1640

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