Percutaneous carpal tunnel release compared with mini-open release using ultrasonographic guidance for both...

Area of Science:

• Orthopedic Surgery
• Minimally Invasive Procedures
• Nerve Entrapment Syndromes

Background:

• Carpal tunnel syndrome (CTS) is a common condition causing median nerve compression.
• Surgical intervention is often required for idiopathic CTS.
• Ultrasonographic guidance is increasingly utilized in carpal tunnel release procedures.

Purpose of the Study:

• To compare the clinical and ultrasonographic outcomes of percutaneous carpal tunnel release (PCTR) and mini-open carpal tunnel release (mini-OCTR).
• To evaluate differences in neurologic recovery, pain, strength, and patient satisfaction between PCTR and mini-OCTR.

Main Methods:

• A comparative study involving 74 hands of 65 women with idiopathic CTS.
• PCTR performed using a specialized device under ultrasonography (4 mm incision).
• Mini-OCTR performed with a combination of direct vision and ultrasonography (1-1.5 cm incision).

Main Results:

• No significant difference in neurologic recovery between PCTR and mini-OCTR groups at follow-up points up to 104 weeks.
• PCTR group demonstrated significantly less postoperative pain, greater grip and key-pinch strength, and higher satisfaction scores at 3 and 6 weeks.
• PCTR group experienced significantly less scar sensitivity at 3, 6, and 13 weeks, with no reported complications in either group.

Conclusions:

• Percutaneous carpal tunnel release (PCTR) achieves comparable neurologic recovery to mini-open carpal tunnel release (mini-OCTR).
• PCTR is associated with reduced postoperative morbidity, including less pain and scar sensitivity.
• Patients undergoing PCTR report earlier functional return and higher satisfaction levels.