Carpal tunnel syndrome occurs when the median nerve is compressed at the wrist. It can cause pain, numbness, tingling, reduced hand strength, and difficulty performing daily activities. Carpal tunnel release surgery is commonly performed when symptoms do not improve with conservative treatment or when nerve compression is severe. However, recovery after surgery may differ between patients, and improvement in nerve conduction may not occur at the same rate as improvement in symptoms and hand function.
The purpose of this prospective observational study is to examine the relationship between electrophysiological recovery of the median nerve and clinical and functional recovery after carpal tunnel release surgery. Adults who are already scheduled to undergo primary carpal tunnel release as part of their routine clinical care will be invited to participate. The decision to perform surgery will be made by the treating physician independently of study participation.
Participants will undergo clinical and functional assessments before surgery and at postoperative week 8 These assessments will include questionnaires about carpal tunnel symptoms and upper-extremity function, pain severity, grip and pinch strength, sensory testing, and clinical examination. Nerve conduction studies will be evaluated before surgery and at postoperative month 3.
The study will assess whether changes in median nerve conduction are associated with changes in symptoms, upper-extremity function, pain, hand strength, and sensory function. The possible effects of age, sex, body mass index, symptom duration, diabetes, and preoperative electrophysiological severity on recovery will also be examined. No experimental drug, device, surgical technique, or additional treatment will be assigned as part of this study.
Age between 18 and 75 years.
Clinical and electrophysiological diagnosis of carpal tunnel syndrome.
Scheduled to undergo primary carpal tunnel release surgery based on routine clinical evaluation.
Availability of a preoperative nerve conduction study.
Previous carpal tunnel release surgery on the study hand.
Planned revision carpal tunnel surgery.
Electrophysiological evidence of generalized polyneuropathy.
Another peripheral neuropathy affecting the median nerve or function of the study hand.
Single group
Primary Carpal Tunnel Release Surgery
Procedure/SurgeryParticipants will undergo primary carpal tunnel release surgery as part of their routine clinical care. The procedure aims to decompress the median nerve by releasing the transverse carpal ligament. The decision to perform surgery, the timing of surgery, and the surgical technique will be determined by the treating physician independently of study participation. The study will not require an experimental surgical technique or any modification of the participant's standard treatment. Participants will undergo clinical and functional follow-up assessments, and median nerve conduction findings will be evaluated before surgery and at postoperative month 6.
Change in Median Nerve Distal Motor Latency
Median nerve distal motor latency will be measured by a standardized nerve conduction study and recorded in milliseconds (ms). Change will be calculated as the postoperative month 6 value minus the preoperative value. A reduction in distal motor latency indicates electrophysiological improvement.
Change in Median Nerve Sensory Nerve Conduction Velocity
Median nerve sensory nerve conduction velocity will be measured by a standardized nerve conduction study and recorded in meters per second (m/s). Change will be calculated as the postoperative month 6 value minus the preoperative value. An increase in sensory nerve conduction velocity indicates electrophysiological improvement.
The Boston Carpal Tunnel Questionnaire consists of the Symptom Severity Scale and the Functional Status Scale. Each item is scored from 1 to 5, and the mean score is calculated separately for each subscale. Higher scores indicate greater symptom severity
The Boston Carpal Tunnel Questionnaire consists of the Symptom Severity Scale and the Functional Status Scale. Each item is scored from 1 to 5, and the mean score is calculated separately for each subscale. Higher scores indicate greater symptom severity or functional limitation. Change will be calculated relative to the baseline score. A reduction in score indicates clinical and functional improvement.
Change in Quick Disabilities of the Arm, Shoulder and Hand Score
Upper-extremity disability will be assessed using the Quick Disabilities of the Arm, Shoulder and Hand questionnaire. The total score ranges from 0 to 100, with higher scores indicating greater disability. Change will be calculated relative to the baseline score. A reduction in score indicates improvement in upper-extremity function.
Change in Median Nerve Sensory Nerve Action Potential Amplitude
Description: Median nerve sensory nerve action potential amplitude will be measured by nerve conduction study and recorded in microvolts (µV). Change will be calculated as the postoperative month 3 value minus the baseline value. A higher amplitude generally indicates better sensory nerve function.
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