Student Research: Michael Laurin Adams

Predictors of Outcome in Surgically Treated Occupationally Related Carpal Tunnel Syndrome
1991

Abstract

Nearly 8000 claims for occupationally related carpal tunnel syndrome (OCTS) were seen in the Washington State worker's compensation system (WSWCS) between 1984-1988. Approximately 40% went on to surgical treatment for this disorder. In 1987 alone, there were 539 surgically treated cases of OCTS within this compensation system. In 1988 this number increased to 756. This 40% rise likely reflects both an increasing incidence as well as greater physician and patient awareness of the condition. A recent national survey of over 400 hand surgeons reflected the magnitude of this medical problem when it reported that the average surgeon in the study saw 117 CTS patients per year and surgically treated 58% of them. The medical disability and human costs of this disorder may be very significant.

Based on characteristic features of the history, physical examination and nerve conduction tests, OCTS is relatively simple to diagnose. The criteria utilized for this diagnosis, however, are quite varied, and the accuracy of this "simple" diagnosis must certainly be questioned. The variability of both surgical outcomes and patient symptomatology may reflect inaccuracy in diagnosis.

This study is intended to evaluate specific demographic, socio-economic, clinical and diagnostic variables that characterize patients within the Washington State Workman's Compensation System (WSWCS) who received surgical treatment for occupationally related CTS. These variables will be examined to determine their association, if any, to surgical outcome. Surgical outcome will be measured primarily by the length of time loss following surgery, used as a surrogate measure for the duration of disability. Additionally, return to work data and clinical outcome, when available, will be evaluated as secondary outcome measures.

Taken from the beginning of thesis.