Endoscopic versus open carpal tunnel release.
OBJECTIVE
This study compared endoscopic carpal tunnel release with the conventional open technique with respect to short- and long-term improvements in functional and clinical outcomes.


METHODS
We assessed 72 outpatients diagnosed with carpal tunnel syndrome. Of these patients, 37 underwent the endoscopic method according to Chow and 35 were assigned to the open method. Improvement in symptoms, severity, and functionality were evaluated at 2 days, 1 week, 2 weeks, and 1 year postoperatively. Changes in clinical outcomes were evaluated at 1 year postoperatively. Complications were also assessed.


RESULTS
Both groups showed similar improvement in all but 1 outcome 1 year after the release; increase in grip strength was significantly higher in the endoscopic group. However, the endoscopic method showed a greater improvement in symptoms and functional status compared with the open method at 2 days, 1 week, and 2 weeks postoperatively. Separate analysis of the questions referring to pain showed that the delay in improvement in the open group was because of the persistence of pain for a longer period. Paresthesias and numbness decrease immediately after the operation with comparable rates for both groups.


CONCLUSIONS
Endoscopic carpal tunnel release provides a faster recovery to operated patients for the first 2 weeks, with faster relief of pain and faster improvement in functional abilities. Paresthesia and numbness subside in an identical manner with the 2 techniques. At 1 year postoperatively, both open and endoscopic techniques seem to be equivalently efficient.
Vasiliadis
Haris S
HS
Department of Orthopaedic Surgery, University of Ioannina, Ioannina, Greece.
Xenakis
Theodoros A
TA
Mitsionis
Grigorios
G
Paschos
Nikolaos
N
Georgoulis
Anastasios
A
D000556:Ambulatory Surgical Procedures / Q000379:methods; D000700:Analgesics / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002349:Carpal Tunnel Syndrome / Q000188:drug therapy / Q000601:surgery*; D003131:Combined Modality Therapy; D019299:Decompression, Surgical / Q000379:methods*; D004192:Discrimination, Psychological; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D010149:Postoperative Pain / Q000453:epidemiology / Q000517:prevention & control; D011930:Reaction Time; D020127:Recovery of Function; D014110:Touch; D016896:Treatment Outcome
D000700:Analgesics; D000893:Anti-Inflammatory Agents