Study Supports Simultaneous Bilateral Carpal Tunnel Release versus Staged Unilateral Surgeries

Bilateral Carpal Tunnel Syn--cropdCarpal tunnel syndrome is the most common nerve compression disorder of the upper extremity, affecting 5 percent of the working population.[1]   On average, carpal tunnel syndrome accounts for 30 days of lost work.[2]

A study reported in the June 4, 2014 issue of The Journal of Bone and Joint Surgery provides support for simultaneous left and right carpal tunnel releases versus staged unilateral release surgeries for bilateral carpal tunnel syndrome.[3]  The study revealed no difference in reported baseline function or disease severity.

Patients who underwent simultaneous bilateral releases had more difficulty with activities of daily living necessary for personal hygiene and independence on the first and second postoperative days.  Thereafter, there was no significant functional difference between the two groups.  Though no patients in the bilateral surgery group declared nighttime difficulties, the unilateral surgery group reported severe sleep disturbance due to pain from hand that had not undergone surgery.

The results support preference for simultaneous bilateral carpal tunnel release.  The bilateral surgery group did require additional home assistance for activities of daily living during the first two post-operative days.  The two groups had no significant difference in recovery time or overall reports of functional ability and disability severity.  Moreover, the simultaneous bilateral carpal tunnel release group returned to full-duty work more quickly than the staged unilateral carpal tunnel release group.

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[1] Concannon, Matthew J. MD; Brownfield, Mona L. MD; Puckett, Charles L MD; The Incidence of Recurrence After Endoscopic Carpal Tunnel Release, Plastic and reconstructive Surgery: Vol. 105(5)April 2000;

[2] U.S. Bureau of Labor Statistics, November 26, 2013, Nonfatal Occupational Injuries and Illnesses Requiring Days away from Work, 2012, www.bls.gov/iif/oshcdnew.htm

[3] Osei, Daniel A., Calfee, Ryan P., Stepan, Jeffrey G., Boyer, Martin I., Coldfarb, Charles A., Gelberman, Richard A.,  Simultaneous Bilateral or Unilateral Carpal Tunnel Release? A prospective Cohort Study of Early Outcomes and Limitations, J Bone Joint Surg Am 2014Jun 4; 96:889.