Related Experiment Video
Updated: Aug 26, 2026
Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
Clinical and Electrophysiological Predictors of 12-Month Functional Recovery after Open Carpal Tunnel Release Using
Mehmet Yalcin1, Uğur Bezirgan1, Yusuf Kıratlıoğlu1
1Ankara University, Orthopedic and Traumatology Department of Hand Surgery, Turkey, Ankara.
Objective:
This study aimed to evaluate the 12-month clinical and functional outcomes of open carpal tunnel release performed using the Wide Awake Local Anesthesia No Tourniquet technique to identify the clinical, electrophysiological, and surgeon-related predictors of postoperative functional recovery.
Methods:
A retrospective cohort of 55 patients who underwent Wide Awake Local Anesthesia No Tourniquet-assisted carpal tunnel surgery between 2021 and 2024 was analyzed. Clinical and electrophysiological parameters were evaluated according to the McKinnon classification, symptom duration, surgeon experience, and thenar muscle condition. Functional outcomes were assessed preoperatively and at 12 months postoperatively using the Michigan Hand Outcomes Questionnaire, Visual Analog Scale, and grip strength measurements.
Results:
Significant postoperative improvements were observed in Michigan Hand Outcomes Questionnaire scores (mean increase:+24 points), pain reduction, and grip strength (all p<0.001). Patients with higher McKinnon stages, longer symptom duration, and preoperative thenar atrophy demonstrated lower functional gains, while greater surgeon experience was associated with superior outcomes. Multivariate analysis confirmed electrophysiological severity, symptom duration, surgeon experience, and thenar atrophy as independent predictors of recovery.
Conclusions:
Open carpal tunnel release performed using the Wide Awake Local Anesthesia No Tourniquet technique was associated with significant improvements in patient-reported function, pain, and grip strength at 12 months. However, because no comparator anesthesia group was included, these findings should not be interpreted as evidence of Wide Awake Local Anesthesia No Tourniquet-specific superiority or comparative effectiveness. Electrophysiological severity, symptom duration, thenar atrophy, and surgeon experience were associated with postoperative recovery and may help inform preoperative patient counseling.
