title: Carpal tunnel release by limited palmar incision vs traditional open technique: randomized controlled trial.
abstract: OBJECTIVE
  To compare a limited palmar incision for carpal tunnel release (CTR) with a traditional open technique, which is still considered the gold standard.
  
  
  METHODS
  Seventy-two patients with a carpal tunnel syndrome were individually randomized into the trial (limited incision CTR) (n=36) and control group (traditional technique CTR) (n=36). In the trial group, skin incision parallel to the thenar crease was made up to 2.5 cm in length, under an operating microscope and endoscopic transillumination. Skin incision in the control group began at the distal border of the carpal ligament, followed the longitudinal crease of the palm, and crossed the base of the palm in a zigzag fashion. Three months after surgery, the patients were asked about symptomatic relief and intervals between the operation and return to their daily activities and work, and examined for scar tenderness and esthetic outcome. Distal motor latency, conduction velocity, scar length, scar width, and operation time were measured.
  
  
  RESULTS
  There were no differences between the two groups in symptomatic relief and electrophysiological parameters. Intervals between the operation and return to daily activities (median 5 days, range 2-15) were shorter in the trial group than in the control group (median 10 days, range 2-21; p<0.001), as well as the intervals between the operation and return to work (median 15 days, range 5-45 vs median 30 days, range 10-60; p<0.001). Scar/pillar tenderness, scar length and width, esthetic outcome, and operation time were significantly better in the trial group.
  
  
  CONCLUSIONS
  Limited palmar incision CTR is as effective and safe as traditional CTR technique, but with better postoperative recovery and cosmetic results.
authors.affiliation: Division of Neurosurgery, Pula General Hospital, Pula, Croatia.
authors.forename: Izabela
authors.initials: I
authors.lastname: Jugovac
authors.forename: Nijaz
authors.initials: N
authors.lastname: Burgić
authors.forename: Vladimir
authors.initials: V
authors.lastname: Mićović
authors.forename: Lorena
authors.initials: L
authors.lastname: Radolović-Prenc
authors.forename: Miljenko
authors.initials: M
authors.lastname: Uravić
authors.forename: Vesna
authors.initials: V
authors.lastname: Golubović
authors.forename: Marin F
authors.initials: MF
authors.lastname: Stancić
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013514:Surgical Procedures, Operative / Q000379:methods; D016896:Treatment Outcome