Early Functional Outcomes and Recovery of Hand Strength After Carpal Tunnel Release

BACKGROUND: Although carpal tunnel release reliably improves symptoms in patients with carpal tunnel syndrome (CTS), the short-term pattern of postoperative recovery in hand strength remains incompletely characterized. Serial measurement of grip and pinch strength, together with patient-reported outcome assessment, may provide a more clinically meaningful description of early recovery after surgery. METHODS: This prospective observational cohort study included 21 adults with clinically and electrophysiologically confirmed CTS who underwent standardized mini-open carpal tunnel release. All participants followed the same structured 12-week home-based postoperative strengthening protocol beginning in the third postoperative week, following the initial wound-healing period. Grip strength (Jamar hydraulic hand dynamometer) and pinch strength were measured preoperatively and at three, nine, and 15 weeks postoperatively. Symptom severity and functional status were assessed using the Boston Carpal Tunnel Questionnaire (BCTQ) preoperatively and at 15 weeks postoperatively. Longitudinal changes in grip and key pinch strength were analyzed using repeated-measures analysis of variance, while changes in BCTQ symptom severity and functional status scores from baseline to 15 weeks were analyzed using paired-samples t-tests. RESULTS: Grip and key pinch strength demonstrated an early reduction during the postoperative period, followed by progressive improvement at subsequent follow-up assessments. Grip strength declined at three weeks, returned toward preoperative values by nine weeks, and exceeded preoperative values by 15 weeks postoperatively (27.52 ± 9.22 kg preoperatively vs. 32.33 ± 7.77 kg at 15 weeks; p < 0.001), while key pinch strength showed a similar recovery pattern over time (7.33 ± 1.77 kg preoperatively vs. 8.10 ± 1.86 kg at 15 weeks; p < 0.001). Patient-reported outcomes demonstrated marked improvement, with significant reductions in BCTQ symptom severity scores (3.22 ± 0.55 to 1.00 ± 0.00; p < 0.001) and functional status scores (2.79 ± 0.62 to 1.02 ± 0.08; p < 0.001) at follow-up. CONCLUSIONS: Early postoperative recovery following carpal tunnel release is characterized by a transient decline in grip and key pinch strength at three weeks, return toward baseline by nine weeks, and improvement beyond baseline by 15 weeks. Objective strength measures and patient-reported outcomes provide complementary information regarding recovery dynamics and may assist clinicians in monitoring early postoperative recovery after carpal tunnel release.