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Symptoms in at least two digits on one hand (to include thumb, index, middle, or ring finger.)
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Wrist or hand surgery within last 6 months
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Hand/ wrist symptoms >1 week
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Previous CTS release on study hand
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Expect to stay in area for 1 year.
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Moderate to severe arthritis involving hand or wrist
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Willing and able to complete phone interviews
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Known tumor, mass, or deformity in the hand or wrist
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Over age 18
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History of severe trauma to the wrist.
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Able to complete questionnaires in English
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Pregnant or lactating
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Any one of these EDS findings
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Motor: Median motor latency (wrist) > = 4.4 ms
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Median Motor amplitude <= 3.8 mV
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Sensory: median-radial (10 cm thumb to wrist) difference >0.5 ms
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EMG (if done) evidence of denervation
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Sensory: Midpalm median-ulnar (8 cm) difference >0.3 ms
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Evidence of diffuse peripheral neuropathy.
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Sensory: Median-ulnar (14 cm digit IV to wrist) difference >0.4 ms
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Thenar atrophy
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Sensory: Combined Sensory index > = 1.0 ms
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(With normal EDS) Night pain that wakes patient AND Positive flick test
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Classic, probable, or possible hand pain diagram.
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Two consecutive weeks of standard (non-surgical) treatment for CTS, including a trial of wrist splints.
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Lack of improvement with conservative treatment documented by at least one of the following:
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Improvement less than 0.75 in the CTSAQ functional?
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Unable to achieve "satisfactory" level of work
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Patient defined symptoms as being "same" or "worse" over the last two weeks.
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Willing to schedule surgery within one week of randomization.
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