Carpal tunnel decompression: two different mini-incision techniques

To compare two different mini-incision surgical techniques for carpal tunnel surgery.

A total of 45 patients in Group 1 underwent carpal tunnel release through a 2-cm longitudinal incision made distal to the flexor crease, whereas the 45 patients in Group 2 underwent carpal tunnel release through a 2-cm longitudinal incision made proximal to the flexor crease. The self-administered Boston Questionnaire was used to assess the severity of patients' symptoms and their functional status, both before and after the surgical intervention and at their final follow-up. Patients were also asked, during the final follow-up, about the pain level of their scar tissue.

There was a significant decrease in the Boston Carpal Tunnel Questionnaire scores for the symptom severity scale and the functional status scale of patients in both groups, pre-operatively, post-operatively at one month and at final follow-up (p < 0.001 for both). The mean operative time for Group 2 was significantly shorter than for Group 1 (p < 0.001). At final follow-up, 11 patients in Group 1 stated they had scar tissue pain, compared to three patients in Group 2. The pain in scar tissue among Group 2 was significantly less than for Group 1 (p = 0.02).

Due to shorter operative times, mini-incisions proximal to the flexor crease can be performed. The absence of relapse and good clinical results make both surgical techniques suitable. For this reason, we consider that the selection of the mini-surgical technique used should depend on the experience and skill of the surgeon.