Carpal tunnel release: a randomized comparison of three surgical methods

Area of Science:

• Orthopedics
• Surgical Innovation
• Hand Surgery

Background:

• Carpal tunnel syndrome (CTS) is a common condition causing hand numbness and pain.
• Surgical interventions aim to relieve median nerve compression.
• Various surgical techniques exist, including open and endoscopic approaches.

Purpose of the Study:

• To compare the efficacy and patient outcomes of carpal tunnel release using classic incision, short incision, and endoscopic techniques.
• To evaluate differences in pain, functional recovery, and return to work.
• To assess the safety and complication rates of each surgical method.

Main Methods:

• A single-blind, randomized controlled trial involving 90 consecutive patients.
• Comparison of three surgical methods: classic incision, short incision, and endoscopic carpal tunnel release.
• Follow-up assessment at 24 weeks, evaluating pain, paresthesia, range of motion, pillar pain, grip strength, and sick leave duration.

Main Results:

• The endoscopic carpal tunnel release group demonstrated significantly shorter sick leave duration.
• No significant differences in pain, paresthesia, range of motion, pillar pain, or grip strength were observed at 24 weeks.
• Intermediate significant differences, particularly in grip strength, favored the endoscopic technique.
• No major advantages were found for the short incision technique compared to others.
• No serious complications were reported across all groups.

Conclusions:

• Endoscopic carpal tunnel release is a safe and effective procedure.
• The endoscopic approach offers the benefit of faster rehabilitation and return to work.
• While long-term functional outcomes may be comparable, the endoscopic method facilitates quicker return to employment.