Carpal tunnel release in super-elderly: safety profile and clinical outcome

Abstract

Introduction: The clinical outcome of carpal tunnel release (CTR) for carpal tunnel syndrome in the super-elderly older than 80 years old remained controversial in the literature. This study aimed at reviewing the functional outcome and patient satisfaction of CTR in the super-elderly in a tertiary hospital as compared to that in a younger control group within a five-year period. Methods: A total of 40 hands in 37 patients that received CTR from 2016 to 2020 were recruited in this study, with 18 hands in super-elderly group (age over 80) and 22 hands in control group (aged 50-54). Demographic data and short-term outcomes were retrieved from patient records. Subjective long-term outcomes were obtained via telephone follow-up (mean follow-up duration 49.3 months), with Boston Carpal Tunnel Questionnaire (BCTQ) used as assessment tool. Results: All cases were performed under local anaesthesia and there were no major complications including nerve injury and wound infection. At 2-month follow-up, mean power grip strength was 74% of contralateral hand in both groups, while mean pinch grip strength was 63% (super-elderly group) and 73% (control group) of contralateral hand respectively. Mean subjective symptom improvement percentage is lower in super-elderly group (53% vs 68%), as well as the mean satisfaction rate (67% vs 84%). There were however no significant differences in the mean symptom-severity score (1.32 vs 1.25) and mean functional-status score (1.92 vs 1.14) of BCTQ. Conclusion: CTR in super-elderly is safe with good clinical outcome comparable to the younger patient group, although the subjective satisfaction rate is generally lower.