Carpal Tunnel Syndrome: Open or Endoscopic Release Surgery Method?

Document Type : RESEARCH PAPER


1 Division of Plastic and Reconstructive Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

2 Division of Plastic and Reconstructive Surgery, Department of Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

3 Medical School, Tehran University of Medical Sciences, Tehran, Iran

4 Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

5 Division of Reconstructive Surgery, Department of Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran


Background: Carpal tunnel syndrome (CTS) or median nerve neuropathy is among the causes of numbness, 
paresthesia, and sensory and motor dysfunction in the affected hand. The objective of this study was to compare open 
and endoscopic carpal tunnel release (ECTR) methods.
Methods: A multicenter, historical cohort study was performed on 47 hands in 46 patients with a clinical diagnosis 
of CTS and a failed trial of conservative treatment. Samples were divided into two groups consisting of 23 patients 
receiving open carpal tunnel release (OCTR) and ECTR. Outcome measurements had been carried out six weeks after 
the operation and included handgrip strength, post-op pain, and missing job days. 
Results: Patients in both groups were comparable regarding baseline characteristics such as age, gender, and handgrip 
strength. Both methods significantly improved handgrip strength. No significant difference was detected between the 
two groups concerning handgrip strength improvement (P=0.700) and sick leave days (P=0.564). Open carpal tunnel 
release resulted in more significant post-op pain (mean 5.91±1.24 compared to 2.43±0.73 after endoscopic release), 
which was significant (P=0.000). No complications were reported with any technique. 
Conclusion: This study revealed that apart from post-op pain, other investigated endpoints were similar in both 
groups. Although the small sample size has limited our ability to draw a conclusive statement, these data suggest 
that there is no need to utilize the endoscopic technique for the optimum result, especially when this method requires 
more advanced equipment and could increase surgery costs. Therefore, both approaches can result in good clinical 
Level of evidence: III


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