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Management of Acute Carpal Tunnel Syndrome: A Systematic Review
Ying C. Ku, BS; Megan Gannon, BS, MMS; Wei Fang, PhD; Rebecca C. Norcini, MD; Kerri M. Woodberry, MD, MBA
Department of Plastic and Reconstructive Surgery, West Virginia University School of Medicine
2023-01-31
Presenter: Rebecca Norcini
Affidavit:
The submission is original work and has not been previously presented at any major meetings
Director Name: Kerri M. Woodberry
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Hand
Introduction: Currently there are no guidelines for managing acute carpal tunnel syndrome and an initial conservative treatment remains controversial. This review aims to investigate associations between recovery outcomes and management approaches for acute carpal tunnel syndrome.
Methods: A literature search of PubMed, Scopus, and CINAHL from 1970 to 2022 was conducted using the keywords carpal tunnel syndrome and acute nerve compression. Acute carpal tunnel syndrome was determined as cases within 12 weeks of symptom onset. Primary data extracted included causes (traumatic or atraumatic), symptom duration (<1 day, 1-7 days, or 8-84 days), intervention (surgical, conservative, or conservative then surgical), and outcome (full recovery or non-full recovery). Logistic regression models and Chi-squared tests were performed to investigate associations among these variables.
Results: A total of 197 patients involving 127 (64.5%) traumatic and 70 (35.3%) atraumatic cases were included. 47% of patients were managed conservatively followed by surgery, 30% conservative only, and 23% surgical only. The traumatic group was associated with better recovery than the atraumatic group (Odds Ratio: 2.60, p=0.02). There were no associations between intervention and causes (p=0.71) or outcome (p= 0.15). No correlation was identified between intervention and outcome (p=0.71) when analyzed separately based on causes (traumatic/atraumatic).
Conclusions: Traumatic acute carpal tunnel syndrome is associated with better recovery than atraumatic etiologies. Surgical intervention was not found to be associated with better outcomes than conservative management regardless of the etiologies.
