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Hand (N Y). 2018 Jul 1:1558944718787892. doi: 10.1177/1558944718787892. [Epub ahead of print]

Comparison of the Short-term and Long-term Effects of Surgery and Nonsurgical Intervention in Treating Carpal Tunnel Syndrome: A Systematic Review and Meta-analysis.

Author information

1
1 Western University, London, ON, Canada.
2
2 St. Joseph's Health Centre, London, ON, Canada.
3
3 University of Toronto, ON, Canada.
4
4 McMaster University, Hamilton, ON, Canada.

Abstract

BACKGROUND:

The objective of the study is to examine the short-term and long-term efficacy of surgical treatment of carpal tunnel syndrome (CTS) compared with conservative treatment (ie, splint, steroid injection, or physical therapy).

METHODS:

Two reviewers searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and PEDro up to September 2017. Quality appraisal and data extraction were performed in duplicate. Patient self-reported functional and symptom changes, as well as improvement of electrophysiological studies, were assessed as outcomes. Meta-analyses were performed in RevMan.

RESULTS:

From 1438 studies identified after searching, 10 remained for analysis after exclusion criteria were applied. Moderate-quality evidence indicated that surgical interventions were superior to splint or steroid injection at 6 months with a weighted mean difference of 0.25 (95% confidence interval [CI], 0.07-0.44) for functional status and 0.64 (95% CI, 0.07-1.21) for symptom severity. The surgical group had better nerve conduction outcomes at 6 months (0.57 [95% CI, 0.05-0.50] ms). No significant differences were observed at 3 or 12 months.

CONCLUSIONS:

Both surgical and conservative interventions provide treatment benefits in CTS. Further studies on long-term outcome are needed.

KEYWORDS:

carpal tunnel syndrome; conservative; efficacy; surgical treatment; systematic review and meta-analysis

PMID:
30015499
DOI:
10.1177/1558944718787892

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