To splint or not after carpal tunnel release: A prospective randomized comparative study.

Introduction: Carpal tunnel syndrome is the predominant form of peripheral nerve neuropathy, which can be managed conservatively in early cases; however, surgery is considered the gold standard if conservative measures failed. Post-operative therapy modalities may differ; some surgeons prefer using a splint while others encourage an early range of motion. Aim of work: This study compared the functional outcomes and assessed the effectiveness, benefits, and drawbacks of two different post-operative protocols following carpal tunnel release: the below-elbow slab and the elastic bandaging. Methods: Forty individuals diagnosed with idiopathic carpal tunnel syndrome who had failed conservative treatment were enrolled. The participants were categorized into two categories.: Group I (with elastic bandaging post-operatively for 3 weeks) and Group II (with below-elbow slab for 3 weeks). The evaluation was conducted using VAS, Boston score, night pain, scar tenderness and hand grip power. Results: Post-operative follow-up revealed a statistically significant variation in VAS scores (p < 0.05), with lower scores in Group II (with slab). However, no statistically significant difference (p > 0.05) was observed in other clinical parameters. Conclusion: Wrist immobilization during the first three weeks post-operatively with a below-elbow volar splint reduced post-operative pain but does not improve functional outcomes compared to the immediate post-operative range of motion in the elastic bandaging after open carpal tunnel release surgery.