This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 130 words of the full text and any section headings.

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.

Ernest W. Johnson, MD
Department of Physical Medicine and Rehabilitation
Ohio State University
Columbus

1. Gerritsen AAM, de Vet HCW, Scholten RJPM, Bertelsmann FW, de Krom MCTF, Bouter LM. Splinting vs surgery in the treatment of carpal tunnel syndrome: a randomized controlled trial. JAMA. 2002;288:1245-1251. FREE FULL TEXT

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

JAMA. 2003;289:420.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Splinting vs Surgery for Carpal Tunnel Syndrome
Margit L. Bleecker
JAMA. 2003;289(4):420.
EXTRACT | FULL TEXT  

Splinting vs Surgery for Carpal Tunnel Syndrome
Daniel L. Menkes
JAMA. 2003;289(4):420-421.
EXTRACT | FULL TEXT  

Splinting vs Surgery for Carpal Tunnel Syndrome
Benjamin M. Sucher
JAMA. 2003;289(4):421.
EXTRACT | FULL TEXT  

Splinting vs Surgery for Carpal Tunnel Syndrome
Andrea Klauser and Michael Schirmer
JAMA. 2003;289(4):421.
EXTRACT | FULL TEXT  

Splinting vs Surgery for Carpal Tunnel Syndrome
Annette A. M. Gerritsen, Henrica C. W. de Vet, Rob J. P. M. Scholten, Frits W. Bertelsmann, Marc C. T. F. M. de Krom, and Lex M. Bouter
JAMA. 2003;289(4):421-422.
EXTRACT | FULL TEXT  

Splinting vs Surgery for Carpal Tunnel Syndrome
Michael I. Weintraub
JAMA. 2003;289(4):422.
EXTRACT | FULL TEXT  

Splinting vs Surgery for Carpal Tunnel Syndrome
E. F. Shaw Wilgis
JAMA. 2003;289(4):422-423.
EXTRACT | FULL TEXT