title: Mini-open blind procedure versus limited open technique for carpal tunnel release: a 30-month follow-up study.
abstract: OBJECTIVE
  To evaluate prospectively the safety and effectiveness of a mini-open blind technique for carpal tunnel release (group A) when compared with a limited open technique (group B).
  
  
  METHODS
  From November 1999 to May 2001 (mean follow-up period, 30 mo) we performed 222 carpal tunnel release procedures on 185 consecutive patients. All patients were affected by mild to moderate median nerve compression. Patients in group A (82 patients, 99 procedures) had a short transverse incision at the wrist (length, 2 cm). We used a manual surgical instrument that helps in blindly dividing the flexor retinaculum because it has an integrated light source. The light makes it possible to locate precisely the tool blade by transillumination. Patients in group B (103 patients, 123 procedures) had a limited longitudinal incision (length, 3-4 cm). The preoperative and postoperative patient statuses were evaluated with an Italian modified version of the Boston Carpal Tunnel questionnaire with a mean of 30 months' follow-up after surgery (range, 24-39 mo).
  
  
  RESULTS
  Group A patients showed better results than group B patients in all of the sections of the Italian modified version of the Boston Carpal Tunnel questionnaire at a mean follow-up period of 19 months, whereas after a mean of 30 months of follow-up evaluation the differences between groups A and B tended to decrease. Disease recurred in 7 group B patients, whereas only 1 patient in group A experienced symptom recurrence at the latest office evaluation.
  
  
  CONCLUSIONS
  The blind mini-invasive technique has been shown to be as safe as traditional techniques but the recovery period is significantly shortened. With the technique we described a low recurrence rate was observed. All patients in group A reported great reduction in preoperative pain and numbness.
authors.affiliation: Department of Orthopedics, University of L'Aquila, L'Aquila, Italy. paolo.cellocco@libero.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Cellocco
authors.forename: Constantino
authors.initials: C
authors.lastname: Rossi
authors.forename: Francesco
authors.initials: F
authors.lastname: Bizzarri
authors.forename: Luigi
authors.initials: L
authors.lastname: Patrizio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Costanzo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008027:Light; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000295:instrumentation / Q000379:methods*; D017060:Patient Satisfaction; D011446:Prospective Studies; D020127:Recovery of Function; D012008:Recurrence; D011795:Surveys and Questionnaires; D016896:Treatment Outcome