Ultrasound as an outcome assessment tool in carpal tunnel syndrome release surgery in physically active adults

Background. Carpal tunnel syndrome (CTS) is one of the most common neuropathies worldwide. Diagnosis is often reliant on clinical examination and history. The role of ultrasound as a diagnostic tool for evaluating postoperative changes is still underutilised. Aim. This study aimed to assess the use of ultrasound in measuring changes in the median nerve following carpal tunnel release (CTR). Materials and methods. A prospective study involving 29 patients with clinically diagnosed CTS. Ultrasound examination was performed preoperatively and three months after CTR, assessing the cross-sectional area of the median nerve at the entrance of the carpal tunnel (CT) and the pronator quadratus muscle (PQ). Paired t-tests and two-way ANOVA were used to evaluate changes after CTR and across demographic variables. Results. A significant reduction in the median nerve cross-sectional area was observed at the CT level (15.45 ± 4.93 mm² preoperatively vs 12.25 ± 3.69 mm² postoperatively; p < 0.001), with an approximate 21% decrease. No significant change was observed at the PQ level (p = 0.097). The two-way ANOVA test showed a significant effect of CTR at the CT (p = 0.011), with no significant effects of sex, age, physical activity, or affected side. No significant changes were observed at the PQ level. Conclusions. Ultrasound is a useful tool for diagnosing and assessing postoperative changes in CTS, particularly at the carpal tunnel level. Changes distal to the compression site were inconsistent and of limited clinical value. Demographic factors did not significantly influence outcomes, suggesting a uniform response to CTR.