Documents Stanek, E.J. 1 results

The role of various influences on the outcomes for carpal tunnel syndrome (CTS) was considered. Based on a review of the current literature, the usual analytical approach examined the hand instead of the patient as the subject of the analysis; this limited understanding of the functional impact of CTS. Studies which used subjects with CTS in only one extremity and used the unaffected extremity as a control have been based on the premise that the unaffected extremity will not develop the condition. Treatment itself may have an effect on the previously unaffected extremity. In some studies, results were analyzed by extremity. Several factors were identified which appear to be associated with the occurrence or the progression of CTS. In a review of 98 patients with bilateral disease, two or more hand specific or upper extremity specific conditions were identified in 34%. Hand specific conditions were noted in 24% and upper extremity specific diagnoses in 14%. Of 115 patients with unilateral CTS at the start, 30% had an additional hand or extremity condition besides the primary CTS affected hand, with 13% having additional difficulties in the unaffected hand. The authors developed models for hand specific response variables, for including systemic factors, for including hand specific factors, and to incorporate treatment for a hand specific outcome. The advantages of including all these aspects into the model are that it provides a more rational approach to research and care of extremity disorders. This allows researchers to address a wider scope of patients and outcomes. They stress the need for more extensive collection of data.