Carpal Tunnel Syndrome; Open or Endoscopic Release Surgery Method?

Document Type : RESEARCH PAPER

Authors

1 Division of plastic and reconstructive surgery, Emam 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 Department of Orthopedic Surgery, 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

Abstract

Introduction: Carpal tunnel syndrome (CTS) or median nerve neuropathy is one of 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 methods.
Methods: A multicenter, historical cohort study was done on 47 hands in 46 patients with a clinical diagnosis of CTS and a failed trial of conservative treatment. Samples were divided into two 23-patient groups receiving open carpal tunnel release (OCTR) and endoscopic carpal tunnel release (ECTR). Outcome measurements had been done six weeks after the operation and included handgrip strength, post-op pain, and missing job days.
Result: Patients in both groups were comparable in respect to baseline characteristics such as age, gender, and handgrip strength. Both methods improved handgrip strength significantly. No significant difference was detected between the two groups in regard to handgrip strength improvement (P 0.700) and sick leave days (P 0.564). Open carpal tunnel release resulted in greater post-op pain (mean 5.91 ± 1.24 compared to mean 2.43 ± 0.73 after endoscopic release), which was significant (P 0.000). No complication was reported in any technique.
Conclusion: This study revealed that apart from post-op pain, other investigated endpoints were similar in both groups. Although 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, and both approaches can result in good clinical outcomes.

Keywords



Articles in Press, Accepted Manuscript
Available Online from 15 February 2022
  • Receive Date: 03 July 2021
  • Revise Date: 25 January 2022
  • Accept Date: 31 January 2022
  • First Publish Date: 15 February 2022