Babak Hajibarati1, Hojjat Molaei2, Alireza Hasanzadeh3, Ali Ahmadzade3, Maryam Mirshahi4, Hosseinali Abdorrazzaghi2. 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.
Abstract
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 outcomes.
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 outcomes.
Entities:
Keywords:
Carpal tunnel syndrome; Endoscopic carpal tunnel release; Endoscopy; Hand strength; Open carpal tunnel release
Authors: Sai K Devana; Andrew R Jensen; Kent T Yamaguchi; Anthony D'Oro; Zorica Buser; Jeffrey C Wang; Frank A Petrigliano; Casimir Dowd Journal: Hand (N Y) Date: 2018-01-11
Authors: Annette A M Gerritsen; Henrica C W de Vet; Rob J P M Scholten; Frits W Bertelsmann; Marc C T F M de Krom; Lex M Bouter Journal: JAMA Date: 2002-09-11 Impact factor: 56.272