Related Experiment Video
Updated: Aug 6, 2026
Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
Endoscopic Versus Open Carpal Tunnel Release in 17,700 Obese Patients: A Propensity-matched Cohort Study
Yousef Tanas1, Landon Hackley2, Stephen Chen3
1From the Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine, Houston, TX.
Background:
In obese patients, short-term outcomes after endoscopic versus open carpal tunnel release (CTR) are not well defined.
Methods:
TriNetX was queried for obese adults undergoing CTR. Propensity score matching (1:1) on demographics, body mass index, comorbidities, and medication exposures produced balanced cohorts for 30-day outcomes (8850 per group) and 90-day outcomes (8606 per group). Outcomes were assessed at 30 and 90 days and reported as risk ratios (RRs) with 95% confidence intervals (CIs).
Results:
Endoscopic CTR demonstrated lower wound morbidity than open CTR, with reduced wound disruption at 30 days (RR 0.339, 95% CI 0.207-0.555) and 90 days (RR 0.341, 95% CI 0.224-0.519) and reduced infection at 30 days (RR 0.237, 95% CI 0.133-0.425) and 90 days (RR 0.341, 95% CI 0.223-0.524) (all P < 0.001). At 90 days, endoscopic CTR also showed lower sepsis (RR 0.500, P = 0.014) and pulmonary embolism (RR 0.435, P = 0.024). Readmissions were lower at 30 days (RR 0.414, 95% CI 0.372-0.461) and 90 days (RR 0.513, 95% CI 0.472-0.556) (both P < 0.001). Revision procedures were more common at 30 days (RR 1.276, 95% CI 1.172-1.389) and 90 days (RR 1.178, 95% CI 1.097-1.265) (both P < 0.001). Differences in deep vein thrombosis, acute kidney injury, myocardial infarction, stroke, pneumonia, urinary tract infection, stiffness, and mortality were not significant.
Conclusions:
Endoscopic CTR in obese patients is associated with fewer short-term wound complications and fewer readmissions than open CTR, though revision procedures were more frequent.