Endoscopic versus open carpal tunnel release: A randomized trial.

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Hand Surgery

Background:

• Carpal tunnel syndrome (CTS) is a common condition.
• Surgical interventions aim to relieve median nerve compression.

Purpose of the Study:

• To compare the efficacy and outcomes of endoscopic carpal tunnel release (ECTR) versus open carpal tunnel release (OCTR).

Main Methods:

• An unbalanced randomized clinical trial involving 123 patients (91 ECTR, 32 OCTR).
• Outcomes assessed by a blinded evaluator included symptom severity, nerve/vascular complications, pain, grip strength, and return to work.
• Follow-up at 1 week, 6 weeks, and 12 weeks.

Main Results:

• Both ECTR and OCTR groups showed improvement in all measured outcomes.
• No significant differences in primary outcomes (symptom severity, complications) were observed between groups at any follow-up point.
• While ECTR showed transient benefits in grip strength and pain at 6 weeks, these differences resolved by 12 weeks. Long-term satisfaction was lower in the ECTR group due to a 5% re-operation rate.

Conclusions:

• No substantial difference in clinical benefit exists between ECTR and OCTR for carpal tunnel release.
• The findings influenced surgical practice at the center, leading to reduced rates of ECTR.