Objective: Our hypothesis was that there is no difference in the results of patients operated after electrophysiologically proven carpal tunnel syndrome, and the patients operated because of typical symptoms and physical examination only. Method: A retrospective evaluation was performed of our database on the patients operated in the Miskolc Hand Surgery Center. The age of the patients, the time interval from the first symptoms, and the result of electroneurography (ENG) was registered. The subjective level of numbness and pain in the fingers was checked preoperatively and postoperatively at 1 week, and at 5 weeks later. For evaluation of the subjective symptoms, a Visual Analogue Scale (VAS) of 1 to 10 was used. Results: In the last year, there were 193 patients operated for carpal tunnel syndrome in our unit. In all, 30.5% of them was operated without any electrophysiological examination. Due to bilateral symptoms, and concomitant other hand disorders, we had to exclude 27 patients from the study. The mean age of the patients was 60.2 in the first group, and 56 in the second. The treatment was the same in all the cases: open carpal tunnel release without synovectomy. The time interval between the first symptoms and the operation was 6 months to 1 year in average for both groups. The preoperative daytime numbness in the fingers was 6.31 VAS points for the patients operated without ENG and 5.63 in the other group. Night pain was 5.8 and 5.5 in the groups. Postoperatively the changes in the daytime numbness was 3.0 VAS points for the group without ENG, and 3.3 VAS points without ENG after 1 week, and 0.2 more points decrement was registered for both groups 5 weeks later. The night pain has decreased to 1.5 points right after the operation regardless of the preoperative ENG result. The overall satisfaction rate of the patients at the 6-weeks control was 9.0 points for the first group, and 8.9 for the second group. Conclusion: The 2 groups of patients turned out to be homologue. There was no significant difference in the preoperative registered data. Postoperatively the tendency of the decreasing daytime numbness and the disappearing night pain was about the same. As the patient’s satisfaction rate was the same in the 2 groups, we can conclude that if the anamnestic information and the physiological examination are typical for carpal tunnel syndrome, the electrophysiological examination is not mandatory for the decision making.
