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Related Experiment Video

Updated: Sep 12, 2025

Metacarpal Small Incision for Carpal Tunnel Syndrome

Metacarpal Small Incision for Carpal Tunnel Syndrome

Published on: April 5, 2024

Endoscopic versus open carpal tunnel release: A randomized trial.

Joy C MacDermid¹, Robert S Richards², James H Roth¹

¹Hand and Upper Limb Centre Clinical Research Laboratory, St. Joseph's Health Centre, London, Ontario, Canada.

The Journal of Hand Surgery

|August 6, 2025

Summary

Endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR) showed no significant long-term differences in outcomes. Patient satisfaction was lower with ECTR due to re-operation rates.

Keywords:

Carpal tunnel endoscopic open randomized trial surgery

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Last Updated: Sep 12, 2025

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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.