The Influence of Self-Reported Hand-Arm Vibration Exposure on Functional Outcomes Following Carpal Tunnel Release.

Stirling, Paul H C; Jenkins, Paul J; Clement, Nicholas D; Duckworth, Andrew D; McEachan, Jane E · J Hand Surg Am · 2020

prospective_cohort · Level II

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Abstract

This study describes the impact of self-reported hand-arm vibration (HAV) exposure on patient-reported outcomes, health-related quality of life, and satisfaction after carpal tunnel release. We prospectively collected data from Quick-Disabilities of the Arm, Shoulder, and Hand (QuickDASH), patient satisfaction, and 5-level EuroQol-5D questionnaires before and after surgery. Patient-reported outcomes were available for 475 patients (78% follow-up at a mean of 14 months). Fifteen patients were excluded, giving a final cohort of 460 patients. A total of 119 patients reported HAV exposure (26%). Median postoperative QuickDASH and QuickDASH improvement were significantly worse in the HAV-exposed group, although both groups improved after surgery. Multivariable linear regression revealed a significantly worse postoperative score and change in QuickDASH in HAV-exposed patients. There was no difference in satisfaction, but after surgery, the 5-level EuroQol-5D score was significantly worse in HAV-exposed patients. Carpal tunnel release in HAV-exposed patients results in a significantly lower improvement in self-reported disability compared with patients without HAV exposure. This study provides important prognostic information for patients with previous HAV exposure undergoing carpal tunnel release. Prognostic III.

Medical subject headings

Anatomy