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Letters
January 22/29, 2003

Splinting vs Surgery for Carpal Tunnel SyndromeSplinting vs Surgery for Carpal Tunnel Syndrome

Author Affiliations
 

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(4):420-423. doi:10.1001/jama.289.4.420-a

To the Editor: I have several concerns about the study by Dr Gerritsen and colleagues.1 First, nerve latencies (even if converted to conduction velocities) are not the best measure either for diagnosis or severity. Amplitudes of compound muscle action or sensory action potentials both proximal and distal to carpal tunnel are the most accurate measures. Second, the outcome measures (except for latencies) are purely subjective, and neither patient nor evaluator were effectively blinded. Third, it is inappropriate to compare adverse effects of the 2 treatments purely on the basis of aggregated numbers, which may obscure a wide range of complications. Reflex sympathetic dystrophy, wound hematoma, and painful scars are not comparable with discomfort from a brace.

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