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Updated: Jun 25, 2026

Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
M J Reid1, L A David, J E Nicholl
1Department of Orthopaedics, Kent and Sussex Hospital, Maidstone and Tunbridge Wells NHS Trust, Royal Tunbridge Wells, Kent, UK.
This study evaluated a one-stop clinic model for treating carpal tunnel syndrome. Patients previously faced long waits for assessment and surgery. The new model allowed patients to be assessed and treated on the same day. The study found that waiting times were significantly reduced, and patients reported high satisfaction and symptom improvement. The authors suggest that this model could be a viable and efficient option for treating carpal tunnel syndrome in outpatient settings.
Area of Science:
Background:
Healthcare systems face increasing pressure to reduce waiting times while maintaining quality outcomes. For carpal tunnel syndrome, a common condition, delays in diagnosis and treatment can worsen symptoms and reduce patient satisfaction. Prior to this initiative, patients in the trust faced long waits for specialist assessment and surgery. It was already known that prolonged waiting periods may lead to dissatisfaction and worsen clinical outcomes. No prior work had resolved how to streamline both assessment and surgery within a single outpatient visit. This gap motivated the development of a one-stop clinic model. The need for a more efficient system was clear, given the high prevalence of carpal tunnel syndrome and the demand for timely care. The challenge was to evaluate whether such a model could maintain clinical standards while reducing delays. The background sets the stage for assessing this novel approach.
Purpose Of The Study:
The study aimed to evaluate a one-stop clinic model for carpal tunnel syndrome treatment. The primary goal was to assess whether this approach could reduce waiting times without compromising clinical outcomes or patient satisfaction. The specific problem was the long delays between referral, assessment, and surgery. The motivation was to improve efficiency in outpatient care. The researchers proposed that a single-day clinic could address these delays. The study focused on whether this model could be both effective and efficient. The purpose was to test the feasibility of same-day consultation and surgery. The researchers sought to measure patient satisfaction and symptom improvement as outcomes.
Main Methods:
Patients were selected based on standard referral letters alone. A single surgeon conducted all assessments in the clinic. Those deemed suitable underwent open carpal tunnel decompression under local anaesthetic on the same day. The surgery was performed as an outpatient procedure. Patients were discharged the same day following surgery. Follow-up was conducted using a patient satisfaction questionnaire. The Boston questionnaire was also used to assess symptom improvement. The study evaluated waiting times, clinical outcomes, and patient satisfaction.
Main Results:
Forty-six patients underwent 63 procedures with an average waiting time of 2.2 months. The waiting time was significantly shorter than the previous 9-month period. Patients reported high levels of satisfaction with the one-stop clinic model. Symptom improvement was reported following treatment. The average waiting time from referral to surgery was reduced to 9 weeks. No major complications were reported in the study. The model maintained clinical standards while improving efficiency. The results suggest that the one-stop clinic is a viable option for treating carpal tunnel syndrome.
Conclusions:
The authors propose that a one-stop carpal tunnel clinic is an efficient and cost-effective model. The study suggests that this approach can reduce waiting times without compromising outcomes. The findings indicate high patient satisfaction and symptom improvement. The model may be suitable for widespread adoption in outpatient settings. The authors suggest that this approach could be a practical solution for managing carpal tunnel syndrome. The study supports the use of a single-day clinic for both assessment and surgery. The results may inform future healthcare delivery models for similar conditions. The authors propose that this model can be replicated in other trusts.
A one-stop carpal tunnel clinic is a model where patients receive both assessment and surgery on the same day, reducing waiting times and improving efficiency.
Patients waited an average of 2.2 months (9 weeks) from referral to surgery, compared to prior waits of up to 9 months.
Open carpal tunnel decompression under local anaesthetic (OCTD/LA) was performed as an outpatient procedure.
Satisfaction was assessed using a patient satisfaction questionnaire and the Boston questionnaire.
The study reported no major complications following the procedures.
The authors propose that the one-stop clinic is an efficient and cost-effective way to treat carpal tunnel syndrome.