Predictors of Scar Pain After Open Carpal Tunnel Release

• Published in: The Journal of hand surgery (American ed.) Vol. 36; no. 6; pp. 1042 - 1046
• Main Authors: Kim, Jae Kwang, MD, PhD, Kim, You Keun, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-06-2011; Elsevier
• Subjects: Adult; Adult and adolescent clinical studies; Aged; Biological and medical sciences; carpal tunnel release; Carpal Tunnel Syndrome - surgery; Cicatrix - etiology; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction; Depression; Diseases of the osteoarticular system; Electrodiagnosis; Female; Follow-Up Studies; Humans; Male; Medical sciences; Middle Aged; Mood disorders; Nervous system (semeiology, syndromes); Neurology; Orthopedics; Pain Measurement; Pain, Postoperative - etiology; Patient Satisfaction; Predictor; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk Factors; scar pain; Surveys and Questionnaires; carpal tunnel release; scar pain; depression; Predictor; Mood disorder; Carpal tunnel syndrome; Nervous system diseases; Compression; Scar; Diseases of the osteoarticular system; Depression; Pain; Orthopedics; Peripheral nerve disease; Predictive factor
• ISSN: 0363-5023; 1531-6564
• DOI: 10.1016/j.jhsa.2011.03.036

Purpose To identify the predictors of scar pain after open carpal tunnel release (CTR). Methods We enrolled 83 patients with idiopathic carpal tunnel syndrome treated by open CTR. All patients completed the Brigham and Women's (Boston) carpal tunnel questionnaire (BCTQ) preoperatively. We assessed levels of depression preoperatively using the Center for the Epidemiological Study of Depression (CES-D) scale, and pain anxiety using the Pain Anxiety Symptoms Scale. At 3 months after surgery, patients were asked to self-assess treatment satisfaction and scar pain using a 10-point ordinal scale and to complete the BCTQ. Results The mean BCTQ-symptom (BCTQ-S) score decreased significantly from 2.7 ± 1.1 preoperatively to 1.6 ± 1.0 at 3 months postoperatively, and mean BCTQ-function score decreased significantly from 2.4 ± 1.1 to 1.4 ± 1.0. Overall, scar pain intensity at 3 months postoperatively ranged from 0 to 8 (mean, 2.4 ± 2.2), and overall satisfaction ranged from 2 to 10 (mean, 7.6 ± 2.6). The intensity of the scar pain was significantly correlated with the CES-D scale and BCTQ-S. Multivariable regression analysis showed that depression, assessed using the CES-D scale, and postoperative symptoms, assessed using the BCTQ-S, predicted scar pain intensity, which accounted for 38% of scar pain intensity variance. Conclusions Depression score and postoperative symptoms predicted scar pain intensity after open CTR. However, the most important contributor to scar pain intensity variance remains unidentified. Type of study/level of evidence Prognostic I