Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
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.
Johnson EW. Splinting vs Surgery for Carpal Tunnel SyndromeSplinting vs Surgery for Carpal Tunnel Syndrome. JAMA. 2003;289(4):420-423. doi:10.1001/jama.289.4.420-a