Carpal Tunnel Syndrome: Open or Endoscopic Release Surgery Method?

Area of Science:

• Orthopedics
• Neurosurgery
• Hand Surgery

Background:

• Carpal tunnel syndrome (CTS) is a common condition causing hand numbness and dysfunction.
• Median nerve neuropathy, or CTS, necessitates surgical intervention when conservative treatments fail.
• Open carpal tunnel release (OCTR) and endoscopic carpal tunnel release (ECTR) are surgical options for CTS.

Purpose of the Study:

• To compare the efficacy of open carpal tunnel release (OCTR) versus endoscopic carpal tunnel release (ECTR).
• To evaluate outcomes including handgrip strength, post-operative pain, and work absence after both surgical methods.

Main Methods:

• A multicenter, historical cohort study involving 46 patients (47 hands) with diagnosed CTS.
• Patients were divided into two groups: 23 undergoing OCTR and 24 undergoing ECTR.
• Outcomes measured at six weeks included handgrip strength, post-operative pain, and job absenteeism.

Main Results:

• Both OCTR and ECTR significantly improved handgrip strength with no significant difference between groups.
• No significant difference was observed in the number of sick leave days between the OCTR and ECTR groups.
• OCTR led to significantly higher post-operative pain scores compared to ECTR (P=0.000).

Conclusions:

• Both OCTR and ECTR provide comparable clinical outcomes regarding handgrip strength and work absence.
• ECTR demonstrates a significant advantage in reducing post-operative pain.
• While both techniques are effective, ECTR may involve higher costs due to specialized equipment, suggesting OCTR is a viable option for optimal results.