Predictors of scar pain after open carpal tunnel release

Abstract

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 © 2011 American Society for Surgery of the Hand.