Comparison of early clinical outcome in carpal tunnel release - mini-open technique with palmar incision vs. endoscopic technique with wrist crease incision

• Published in: BMC musculoskeletal disorders Vol. 25; no. 1; p. 251
• Main Authors: Nakamichi, Ryo, Saito, Taichi, Shimamura, Yasunori, Hamada, Masanori, Nishida, Keiichiro, Ozaki, Toshifumi
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 01-04-2024; BioMed Central; BMC
• Subjects: Arm; Care and treatment; Carpal tunnel release; Carpal tunnel syndrome; Diagnosis; Endoscopy; Evaluation; Ligaments; Mini-open; Pain; Patient outcomes; Patient satisfaction; Patient-oriented evaluation; Patients; Surgeons; Surgery; Surgical techniques; Sutures; Velocity; Wrist; Japan; Carpal tunnel syndrome; Mini-open; Endoscopy; Patient-oriented evaluation
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-023-07151-w

The purpose of this study was to examine two techniques for Carpal Tunnel Syndrome, mini-Open Carpal Tunnel Release (mini-OCTR) and Endoscopic Carpal Tunnel Release (ECTR), to compare their therapeutic efficacy.
Sixteen patients who underwent mini-OCTR in palmar incision and 17 patients who underwent ECTR in the wrist crease incision were included in the study. All patients presented preoperatively and at 1, 3, and 6 months postoperatively and were assessed with the Visual Analogue Scale (VAS) and the Disabilities of Arm, Shoulder and Hand Score (DASH). We also assessed the pain and cosmetic VAS of the entire affected hand or surgical wound, and the patient's satisfaction with the surgery.
In the objective evaluation, both surgical techniques showed improvement at 6 months postoperatively. The DASH score was significantly lower in the ECTR group (average = 3 months: 13.6, 6 months: 11.9) than in the mini-OCTR group (average = 3 months: 27.3, 6 months: 20.6) at 3 and 6 months postoperatively. Also, the pain VAS score was significantly lower in the ECTR group (average = 17.1) than in the mini-OCTR group (average = 36.6) at 3 months postoperatively. The cosmetic VAS was significantly lower in the ECTR group (average = 1 month: 15.3, 3 months: 12.2, 6 months: 5.41) than in the mini-OCTR group (average = 1 month: 33.3, 3 months: 31.2, 6 months: 24.8) at all time points postoperatively. Patient satisfaction scores tended to be higher in the ECTR group (average = 3.3) compared to the mini-OCTR group (average = 2.7).
ECTR in wrist increase incision resulted in better pain and cosmetic recovery in an early postoperative phase compared with mini-OCTR in palmar incision. Our findings suggest that ECTR is an effective technique for patient satisfaction.