Endoscopic Versus Open Carpal Tunnel Release: Is Early Functional Recovery Different Across Occupational and...

Both endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR) are effective surgical treatments for carpal tunnel syndrome. Prior studies suggest that ECTR may facilitate faster early recovery and return to both work and activity; however, comparative outcomes among patients with varying occupational and recreational hand demands remain incompletely characterized.

A prospective comparative study was conducted in 125 patients undergoing carpal tunnel release, including 70 ECTR and 55 OCTR procedures. Primary outcomes included changes in Quick Disabilities of the Arm, Shoulder, and Hand scores, time to return to activities of daily living (ADLs), work, and recreational activities. Subgroup analyses were performed according to occupational and recreational hand-demand levels.

Patients undergoing ECTR demonstrated greater overall improvement compared with those undergoing OCTR (-7.9 ± 27.2 vs 2.9 ± 25.0, P = .0264) at postoperative follow-up. Time to return to ADLs and work was similar between groups. However, ECTR patients returned to recreational activities significantly earlier than OCTR patients (14 vs 31 days, P = .0022). Subgroup analyses demonstrated earlier return to work following ECTR among patients with medium/heavy occupational demands (14 vs 36 days, P = .0346) and earlier return to recreational activities among those participating in high hand-demand activities (25 vs 60 days, P = .0004).

Endoscopic carpal tunnel release was associated with improved early functional recovery and earlier return to high hand-demand occupational and recreational activities compared with OCTR. Although overall return to ADLs and work was similar between groups, ECTR may provide clinically meaningful benefits for patients with physically demanding lifestyles.