Ulnar two-point discrimination following endoscopic carpal tunnel release

Area of Science:

• Orthopedics
• Neurosurgery
• Hand Surgery

Background:

• Carpal tunnel syndrome (CTS) involves median nerve compression at the wrist, causing pain and sensory loss.
• Traditional open carpal tunnel release can improve ulnar nerve function, but its effect on sensation is debated.
• Endoscopic techniques offer a minimally invasive alternative for carpal tunnel release.

Purpose of the Study:

• To investigate the efficacy of endoscopic carpal tunnel release in improving two-point discrimination (2PD) in both median and ulnar nerve distributions.
• To analyze the impact of patient demographics (sex, age, diabetes, smoking status) on post-operative sensory outcomes.

Main Methods:

• Retrospective review of 143 patients undergoing endoscopic carpal tunnel release from April 2016 to June 2019.
• Collected data included patient demographics, pre- and post-operative 2PD measurements in median and ulnar nerve territories, and complications.
• Statistical analysis was performed to assess the significance of improvements and the influence of various patient factors.

Main Results:

• Significant improvements in 2PD were observed in both median nerve (7.7 mm to 4.4 mm, p < 0.001) and ulnar nerve (5.7 mm to 4.1 mm, p < 0.001) distributions post-surgery.
• Patient sex, age, diabetes mellitus, and smoking status did not significantly impact the improvements in 2PD.
• Endoscopic carpal tunnel release effectively decompressed both the carpal tunnel and Guyon's canal.

Conclusions:

• Endoscopic carpal tunnel release is an effective treatment for improving sensory function, as measured by 2PD, in both median and ulnar nerve distributions.
• The procedure demonstrates benefits beyond the primary median nerve territory, positively affecting the ulnar nerve distribution.
• Demographic factors like age, sex, diabetes, and smoking do not appear to significantly alter the positive sensory outcomes following this surgical approach.