Minimal clinically important difference is lower for carpal tunnel syndrome patients undergoing injection versus surgery

Abstract

and none required physical therapy. One patient reported mild pain at the base of the ipsilateral 5th metacarpal up to 9 months postoperatively. The others reported prompt and complete resolution of preoperative pain, noted no functional deficits or wrist weakness, were satisfied with the procedure, and to our knowledge, have not had any late complications. We believe that lengthening the ECU decreases tension in the tendon, which relieves painful stenosis or subluxation. Painless postoperative subluxation may occur. Subluxation or stenosis might be eliminated altogether by performing an ECU tenotomy (Figure 1(d)). However, the senior author favours lengthening over tenotomy to preserve some ECU function, in case the ECU should be called on as a donor tendon in the future, and because patients may be averse to a procedure that definitively eliminates the function of a body part. We recognize that neither of these potential benefits have been subjected to objective assessment. A prospective study including outcome measures is in order to determine the precise indications and efficacy of ECU lengthening.