Minimally invasive ultrasound-guided carpal tunnel release: long-term clinical outcomes

In cases of severe or refractory carpal tunnel syndrome (CTS), carpal tunnel release (CTR) can be performed using open surgery, endoscopic techniques, or minimally invasive approaches under high-resolution ultrasound (HRUS) guidance. This study aimed to evaluate the long-term clinical outcomes following HRUS-guided CTR.A retrospective analysis was conducted on 302 HRUS-CTR cases. Patients who were available for a phone interview and had a minimum follow-up period of one year were assessed using the Boston Carpal Tunnel Questionnaire (BCTQ). Symptom severity and functional limitations were compared before and after the procedure.Of the 302 cases screened, 111 cases had to be excluded due to unavailability for the phone call, missing data, or death. Accordingly, 191 cases were included. The average patient age was 60.4 ± 15.5 years (range: 19 to 87 years). 126 cases (66%) were female and 65 cases (34.0%) were male. Overall, there was a significant reduction of 91.9% in CTS-related symptom severity and frequency for all items recorded in the questionnaire. Similarly, a significant reduction of 84.8% in difficulty with all self-reported daily activities was found. In addition, the procedures were performed by four physicians showing no significant differences in technical success and symptoms reduction.HRUS-CTR is a safe and effective method for the treatment of CTS, showing a statistically but mostly clinically significant reduction in symptom severity and hand discomfort, which persisted 1 year after release and should therefore be considered as an alternative approach to open or endoscopic CTR.