Clinical experience of open carpal tunnel release and Camitz operation in elderly Chinese patients

SH Wan, TC Wong, TH Yip, FK Ip
Department of Orthopaedics and Traumatology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong

OBJECTIVE. To report preliminary experience on the Camitz operation for elderly Chinese patients in a Hong Kong public hospital.

DESIGN. Retrospective study.

SETTING. Tertiary referral hospital with hand surgery service in Hong Kong.

PATIENTS. Between January 2000 and January 2004, patients with carpal tunnel syndrome having the Camitz operation were recruited. They were assessed using the measurements of pinch and grip power, sensation, the Kapandji score, and functional grading as well as complications encountered during the subsequent follow-up.

INTERVENTION. The Camitz operation.

RESULTS. A total of 21 patients (8 male and 13 female; mean age, 70 years) were recruited. The mean duration of follow-up was 15 months. There was significant improvement in pinch power, grip power, and hand functions, as well as a positive correlation between the functional score and the Kapandji score. No major complication was recorded. One patient with pre-existing osteoarthritis of the ring finger developed contracture of the proximal interphalangeal joint.

CONCLUSION. The Camitz operation is a simple, effective, and safe means of improving hand function in elderly Chinese patients with long-standing carpal tunnel syndrome and thenar muscle atrophy. Newly acquired strength in antepulsion of thumb resulted in improved pinch, grip, and hand function in this patient group.

Hong Kong Med J 2007;13:348-52

Key words: Aged; Carpal tunnel syndrome; Hand/surgery; Thumb