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KMID : 0621520150200030089
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Journal of the Korean Society for Surgery of the Hand
2015 Volume.20 No. 3 p.89 ~ p.95
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Carpal Tunnel Syndrome in Patients Undergoing Long-Term Hemodialysis Therapy: Clinical Characteristics and Results of Surgical Treatment
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Park Ho-Jin
Lee Dae-Sung
Yun Tae-Kyoung
Ahn Duck-Sun
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Abstract
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Purpose: Carpal tunnel syndrome (CTS) has become increasingly recognized as a complication of long-term hemodialysis. This study evaluated the clinical characteristics and compared the results of carpal tunnel release for CTS patients with or without hemodialysis.
Methods: We retrospectively reviewed the clinical characteristics and surgical outcomes of 49 chronic hemodialysis patients with 83 CTS hands. Also, 100 patients were selected for the control group. Patient characteristics, accompanying systemic conditions, operative outcomes were compared.
Results: In hemodialysis group, the mean age and hemodialysis duration were 59.5±10.5 years and 4.1±2.5 years, respectively. Of the 83 hands with CTS, 45 (54.2%) had arteriovenous fistulas, while 38 (45.7%) did not (p=0.02). Most (81.6%) of the patients reported symptom improvement after surgical treatment, and the remaining patients (18.4%) reported persistent and recurrent symptoms. Rates of remaining symptoms and reoperations were significantly higher in the CTS patients with hemodialysis group.
Conclusion: Majority of CTS patients with hemodialysis have much improved after transverse carpal ligament release. However, they showed higher recurrence than idiopathic CTS patients. In recurrent patients, use of the extended carpal tunnel release is effective in symptom relief.
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KEYWORD
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Carpal tunnel syndrome, Hemodialysis, Chronic kidney failure
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