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Impact of smoking and preoperative electrophysiology on outcome after open carpal tunnel release
Authors:Erik Dahlin  Anders Björkman  Niels O.B. Thomsen  Gert S. Andersson  Lars B. Dahlin
Affiliation:1. Department of Hand Surgery, Lund University, Sk?ne University Hospital, Malm?, Sweden;2. Department of Clinical Sciences Lund, Clinical Neurophysiology, Lund University and Sk?ne University Hospital, Sweden;3. Department of Translational Medicine–Hand Surgery, Lund University, Malm?, Sweden
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
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