Abstract:

Objectives: Carpal tunnel syndrome (CTS) is common amongst women. We investigated gender differences in neurography values preoperatively and in QuickDASH scores before and one year after open carpal tunnel release. Methods: Patients that underwent open carpal tunnel release (n=493) during 18 months due to primary CTS were enrolled. Data were collected from medical records, QuickDASH questionnaires and preoperative neurographies. The patients filled out the QuickDASH questionnaire pre- and 12 months postoperatively and were instructed to rate his/her ability [range from 0 (no difficulty) to 5 (impossible to perform)] to do the listed activities during the last week. Results: Preoperatively, women (n=343) had higher sensory amplitudes in the median nerve in the thumb (median 7 µV IQR 3-12 vs. 3 IQR 0-7; p<0.0001) and in the middle finger (median 5 µV IQR 1-10 vs. 2 IQR 0-5; p<0.0001) than men, but sensory conduction velocity at wrist level did not differ. Total QuickDASH scores were higher both preoperatively (55 [36-68] vs. 39 [26-58]; p<0.0001) and postoperatively (22 [7-50] vs. 14 [2-39]; p<0.05) in women, but there was no difference in the change in total score. Eighty-four (25%) women and 40 (27%) men had a change in total score <8, i.e. less than the minimal clinically important difference. Conclusion: Women rate their symptoms higher in the QuickDASH than men before and after surgery, while men have more severe nerve damage on preoperative neurography.

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