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No advantage of plaster casting following carpal tunnel release: A randomized controlled study

Johannes Svegard, Astrid Nordvall Persson, Christina Zetterlund, Björn Alkner
Department of Orthopaedics, Eksjö, Region Jönköping County and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
DOI: 10.2340/16501977-2788

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This article has been accepted for publication in Journal of Rehabilitation Medicine and is currently being edited and typeset. Readers should note that article shown below have been fully refereed, but have not been through the copy-editing and proof correction process. Only Abstract is possible to read. When this process is finalized the complete paper will be able to find.

Abstract

Objective: To compare the effects of 2 postoperative regimens following carpal tunnel release: plaster casting and elastic bandaging.
Design: A randomized controlled study.
Patients: Patients with carpal tunnel syndrome and planned surgical carpal tunnel release were invited to participate.
Methods: A total of 94 patients were randomized to either plaster casting or elastic bandaging to be used 2 weeks postoperatively. Muscle strength, pain rated on a visual analogue scale, range of movement, sensibility, oedema, and different scores regarding symptoms and function were measured before and 2, 4, 6, 8 and 26 weeks after surgery.
Results: No differences were found between the 2 groups for any measurement, except for the Disabilities of the Arm, Shoulder and Hand (DASH) Health score and daily function, rated 2 weeks postoperatively, in which the bandage group scored better. Both groups improved significantly over time for all measurements, sensibility was improved [AQ16] after 2 weeks, while strength was not fully recovered until week 26.
Conclusion: Following carpal tunnel release no benefits were found in using plaster casting, compared with elastic bandaging. Among these patients there was more discomfort during plaster casting compared with elastic bandaging; therefore plaster casting is not recommended following this type of surgery.

Lay Abstract

No clear consensus exists as to the benefits of use of plaster casting following carpal tunnel release. This study aimed to compare 2 different postoperative regimens in a randomized controlled study. A total of 94 patients were randomized to either plaster casting or elastic bandage to be used for 2 weeks after surgery for carpal tunnel release. Muscle strength, rated pain, range of movement, sensibility, oedema, and different scores regarding symptoms and function were measured before and 2, 4, 6, 8 and 26 weeks after surgery. No differences were found between the 2 groups for any measurement, except for health score and rated daily function 2 weeks postoperatively, in which the bandage group scored better. Both groups improved significantly over time for all measurements, sensibility was improved after 2 weeks, while strength was not fully recovered until week 26. This study found no benefits, but some disadvantages, of plaster casting following carpal tunnel release, and therefore plaster casting is not recommended for these patients.

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