Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2020, vol. 29, nr 8, August, p. 979–982

doi: 10.17219/acem/122167

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

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The effect of unilateral carpal tunnel release on the non-operated contralateral hand

Andrzej Żyluk1,A,C,D,E,F, Paweł Dec1,B,C,D, Piotr Puchalski1,B,C

1 Clinic of General and Hand Surgery, Pomeranian Medical University in Szczecin, Poland


Background. Carpal tunnel syndrome (CTS) is often (60–90%) a bilateral condition. It has been suggested that patients with bilateral disease may benefit in the non-operated hand after unilateral surgery.
Objectives. To investigate the effect of unilateral carpal tunnel release on the non-operated contralateral hand.
Material and Methods. In 186 patients with bilateral CTS, a number of measurements were performed prior to surgery. The patients were scheduled for surgery on the other hand operation 3 months after the first. Upon admission, the same measurements were performed on the still unoperated hand.
Results. All subjective variables were significantly better in the hand scheduled for operation as compared to the second one. Pain intensity was lower by a mean of 0.8 on a numeric rating scale (NRS); Levine symptom and function scores were lower by a mean of 0.7 and 0.3, respectively. Digital sensibility and grip strength were also better, but the changes were without clinical or statistical significance. Asked directly about the status of the non-operated hand, 109 patients (64%) reported improvement, 40 (23%) noted no change and 21 (13%) deterioration.
Conclusion. Regardless of the reasons for improvement, this study demonstrates that 64% of patients feel partial relief in the non-operated hand after unilateral carpal tunnel release.

Key words

outcome measures, carpal tunnel syndrome etiology, bilateral manifestation, carpal tunnel surgery

References (29)

  1. Mitake T, Iwatsuki K, Hirata H. Differences in characteristics of carpal tunnel syndrome between male and female patients. J Orthop Sci. 2019;S0949-2658(19)30339-2. doi:10.1016/j.jos.2019.10.017
  2. Zyluk-Gadowska P, Zyluk A. Factors affecting the outcomes of carpal tunnel surgery: A review. Handchir Mikrochir Plast Chir. 2016;48:260–265.
  3. Zyluk A, Zyluk-Gadowska P, Kolodziej L, Szlosser Z. An analysis of patient’s and disease related factors predictive of the outcomes of surgery for carpal tunnel syndrome. Handchir Mikrochir Plast Chir. 2020;52:11–17.
  4. Alimohammadi E, Bagheri SR, Hadidi H, Rizevandi P, Abdi A. Carpal tunnel surgery: Predictors of clinical outcomes and patients’ satisfaction. BMC Musculoskelet Disord. 2020;21:51.
  5. Jenkins PJ, Watts AC, Duckworth AD, McEachan JE. Socioeconomic deprivation and the epidemiology of carpal tunnel syndrome. J Hand Surg Eur Vol. 2012;37(2):123–129.
  6. Zyluk A, Walaszek I, Szlosser Z. No correlation between sonographic and electrophysiological parameters in carpal tunnel syndrome. J Hand Surg Eur Vol. 2014;39(2):161–166.
  7. Zyluk A, Walaszek I. The effect of the involvement of the dominant or non-dominant hand on grip/pinch strengths and the Levine score in patients with carpal tunnel syndrome. J Hand Surg Eur Vol. 2012;37(5):427–431.
  8. Bagatur AE, Zorer G. The carpal tunnel syndrome is a bilateral disorder. J Bone Joint Surg Br. 2001;83(5):655–658.
  9. Dec P, Zyluk A. Bilateral carpal tunnel syndrome: A review. Neurol Neurochir Pol. 2018;52(1):79–83.
  10. Moser VL, Krimmer H, Lanz U. Bilateral carpal tunnel syndrome with familial accumulation. Handchir Mikrochir Plast Chir. 2005;37:176–178.
  11. Alford JW, Weiss AP, Akelman E. The familial incidence of carpal tunnel syndrome in patients with unilateral and bilateral disease. Am J Orthop (Belle Mead NJ). 2004;33(8):397–400.
  12. Padua L, Padua R, Nazzaro M, Tonali P. Incidence of bilateral symptoms in carpal tunnel syndrome. J Hand Surg Br. 1998;23(5):603–606.
  13. Unglaub F, Wolf MB, Dragu A, Horch RE. Bilateral atypical muscles causing acute bilateral carpal tunnel syndrome in recreational climber. Arch Orthop Trauma Surg. 2010;130(1):37–40.
  14. Zhang D, Janssen SJ, Blazar P, Earp BE. Predictors of future contralateral carpal tunnel release at the time of unilateral surgery. J Hand Surg Am. 2019;44(9):e800–e809.
  15. Yoon ES, Kwon HK, Lee HJ, Ahn DS. The outcome for the non-operated contralateral hand in carpal tunnel syndrome. Ann Plast Surg. 2001;47(1):20–24.
  16. Unno F, Lucchina S, Bosson D, Fusetti C. Immediate and durable clinical improvement in the non-operated hand after contralateral surgery for patients with bilateral carpal tunnel syndrome. Hand (N Y). 2015;10(3):381–387.
  17. Afshar A, Yekta Z, Mirzatoluei F. Clinical course of the non-operated hand in patients with bilateral idiopathic carpal tunnel syndrome. J Hand Surg Am. 2007;32(8):1166–1170.
  18. Puchalski P, Zyluk A, Zyluk-Gadowska P. An analysis of the course of carpal tunnel syndrome before operation. Acta Orthop Belg. 2017;83(1):22–29.
  19. Rodrigues JN, Mabvuure NT, Nikkhah D, Shariff Z, Davis TR. Minimal important changes and differences in elective hand surgery. J Hand Surg Eur Vol. 2015;40(9):900–912.
  20. Fernández-de-las-Peñas C, de la Llave-Rincón AI, Fernández-Carnero J, Cuadrado ML, Arendt-Nielsen L, Pareja JA. Bilateral widespread mechanical pain sensitivity in carpal tunnel syndrome: Evidence of central processing in unilateral neuropathy. Brain. 2009;132(Pt 6):1472–1479.
  21. Zambelis T, Tsivgoulis G, Karandreas N. Carpal tunnel syndrome: Associations between risk factors and laterality. Eur Neurol. 2010;63(1):43–47.
  22. Mellet E, Mazoyer B, Leroux G, Joliot M, Tzourio-Mazoyer N. Cortical asymmetries during hand laterality task vary with hand laterality: A f-MRI study in 295 participants. Front Hum Neurosci. 2016;10:628.
  23. Fornander L, Nyman T, Hansson T, Brismar T, Engström M. Inter-hemispheric plasticity in patients with median nerve injury. Neurosci Lett. 2016;628:59–66.
  24. Maeda Y, Kettner N, Kim J, et al. Primary somatosensory/motor cortical thickness distinguishes paresthesia-dominant from pain-dominant carpal tunnel syndrome. Pain. 2016;157(5):1085–1093.
  25. Tecchio F, Padua L, Aprile I, Rossini PM. Carpal tunnel syndrome modifies sensory hand cortical somatotopy: A MEG study. Hum Brain Mapp. 2002;17(1):28–36.
  26. Druschky K, Kaltenhäuser M, Hummel C, et al. Alteration of the somatosensory cortical map in peripheral mononeuropathy due to carpal tunnel syndrome. Neuroreport. 2000;11(17):3925–3930.
  27. Dhond RP, Ruzich E, Witzel T, et al. Spatio-temporal mapping cortical neuroplasticity in carpal tunnel syndrome. Brain. 2012;135(10):3062–3073.
  28. Maeda Y, Kettner N, Holden J, et al. Functional deficits in carpal tunnel syndrome reflect reorganization of primary somatosensory cortex. Brain. 2014;137(6):1741–1752.
  29. Chacur M, Milligan ED, Gazda LS, et al. A new model of sciatic inflammatory neuritis (SIN): Induction of unilateral and bilateral mechanical allodynia following acute unilateral peri-sciatic immune activation in rats. Pain. 2001;94(3):231–244.