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Updated: Aug 25, 2025

Metacarpal Small Incision for Carpal Tunnel Syndrome
04:08

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Published on: April 5, 2024

601

Carpal Tunnel Syndrome: Open or Endoscopic Release Surgery Method?

Babak Hajibarati1, Hojjat Molaei2, Alireza Hasanzadeh3

  • 1Division of Plastic and Reconstructive Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

The Archives of Bone and Joint Surgery
|October 19, 2022
PubMed
Summary

Open and endoscopic carpal tunnel release offer similar outcomes for handgrip strength and work absence. Endoscopic carpal tunnel release (ECTR) resulted in less post-operative pain compared to open carpal tunnel release (OCTR).

Keywords:
Carpal tunnel syndromeEndoscopic carpal tunnel releaseEndoscopyHand strengthOpen carpal tunnel release

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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.