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In Reply: Dr Bleecker states that we should have excluded individuals with work-related CTS. We doubt that absence of exposure to ergonomic stressors in the surgery group is the major reason for the difference in success rates between the groups. In our study, only 28% of the patients in the surgery group and 37% in the splint group indicated that their complaints might have been due to their normal daily activities, including work. Furthermore, absence from paid labor (during the whole trial) was only 12 days on average in the surgery group.

Dr Johnson suggests that nerve latencies are not the best measure for the diagnosis of CTS. Although we also measured amplitudes, the inclusion criteria were based on the current protocol of the Dutch Association of Clinical Neurophysiology. The primary outcome measures used in our study were subjective, as these are the most important for clinical practice. Although we . . . [Full Text of this Article]

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