Comparison of use of plaster casting versus elastic bandage following carpal tunnel release: a randomized controlled study

Abstract

Objective: To compare the effects of two postoperative regimens following carpal tunnel release; plaster casting and elastic bandaging. Design: A randomized controlled study. Patients: Patients with carpal tunnel syndrome and planned surgical carpal tunnel release were invited to participate. Methods: A total of 94 patients were randomized to either plaster casting or elastic bandaging to be used 2 weeks postoperatively. Muscle strength, pain rated on a visual analogue scale, range of movement, sensibility, oedema, and different scores regarding symptoms and function were measured before and 2, 4, 6, 8 and 26 weeks after surgery. Results: No differences were found between the 2 groups for any measurement, except for the DASH (Disability of the Arm, Shoulder and Hand) Health Score and daily function, rated 2 weeks postoperatively, in which the bandage group scored better. Both groups improved significantly over time for all measurements, sensibility was improved after 2 weeks, while strength was not fully recovered until week 26. Conclusion: Following carpal tunnel release no benefits were found in using plaster casting, compared with elastic bandaging. Among these patients there was more discomfort during plaster casting compared with elastic bandaging; therefore plaster casting is not recommended following this type of surgery.

Keywords

• carpal tunnel syndrome
• hand strength
• range of motion
• rehabilitation
• self-assessment.