OUTCOME OF CARPAL-TUNNEL SURGERY IN WASHINGTON-STATE WORKERS COMPENSATION

All cases of occupational carpal tunnel syndrome (OCTS) who received surgery for this condition in the Washington State workers' compensation system were identified using claim and physician billing databases. One hundred ninety-one incident surgical cases were identified between July 1, 1987 and December 31, 1987, and were followed up a mean of 3 years postoperatively for clinical, disability, and return to work outcomes. Medical record and claim file review was required for clinical and employment information. The mean age of all patients was 36.6 years, 48% were female, and 40% received bilateral surgery. The mean time from claim filing to surgery was 187 days. Ninety-eight percent of cases met the National Institute for Occupational Safety and Health (NIOSH) case definition for OCTS. Relief of pain was complete or modest in 86% (124/145) and only 14% of cases reported no improvement in symptoms. Mean duration of disability (time loss) postoperatively was nearly 4 months, and 8% of cases exceeded 1 year of time loss. The majority of cases returned to their same job (67%) or to a different job (15%). Workers in high risk occupations were less likely to return to the same job after CTS surgery compared to those in lower risk occupations (61% vs. 75%, p = 0.08). In this population, no association was seen between any outcome and age, gender, marital status, or baseline wage. Duration of disability was not significantly related to preoperative severity of OCTS or to more specific case criteria for this condition. These findings suggest that disability following surgery for OCTS may be related to other medical, psychosocial, administrative, legal, or work-related factors not evaluated in this study. (C) 1994 Wiley-Liss, Inc.