Staged versus simultaneous bilateral endoscopic carpal tunnel release: an outcome study.
BACKGROUND
This study compared outcomes of bilateral simultaneous endoscopic carpal tunnel release to staged release using the Levine-Katz outcome instrument and physical measurements.


METHODS
Seventy-one patients were evaluated preoperatively and at 6 months postoperatively. One group underwent simultaneous releases, a second group underwent staged releases 1 to 3 weeks apart, and a third underwent staged releases more than 3 weeks apart. Preoperative data included age, gender, race, medical history, initial symptom severity score, and body mass index. Preoperative and postoperative data included Semmes-Weinstein testing, grip and pinch strength, Tinel's sign, Phalen's test, Levine-Katz questionnaire, occupational history, postoperative complications, and patient satisfaction.


RESULTS
Groups were similar demographically except that the simultaneous group had more men and patients were younger. Level of preoperative symptom severity was similar in all groups. Physical measurements were similar for all groups preoperatively and improved similarly at follow-up. All groups improved Levine-Katz mean symptom severity score and functional status score at follow-up. The groups had no significant difference in number of complications, and patient satisfaction was similar.


CONCLUSIONS
In selected patients, bilateral simultaneous endoscopic carpal tunnel release has an outcome similar to that for surgery staged weeks apart. However, patients who choose simultaneous surgery may benefit from a shorter postoperative disability period and earlier return to work.
Nesbitt
Kristin S
KS
Curtis National Hand Center, Union Memorial Hospital, Baltimore, Md. 21218, USA.
Innis
Peter C
PC
Dubin
Norman H
NH
Wilgis
E F Shaw
EF
D000203:Activities of Daily Living; D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D011446:Prospective Studies; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome