title: Surgical techniques and return to work following carpal tunnel release: a systematic review and meta-analysis.
abstract: BACKGROUND
  This systematic review was conducted to evaluate return to work (RTW) following minimally invasive carpal tunnel surgery versus open carpal tunnel release. This study also assesses how RTW as an outcome measure was examined in previous randomized controlled trials (RCTs).
  
  
  METHODS
  The bibliographic databases Medline, AMED and CINAHL were systematically searched. We found 15 relevant RCTs. Meta-analysis was possible only for four studies.
  
  
  RESULTS
  The result indicates that minimally invasive surgery offers earlier return to work compared to open carpal tunnel release (mean difference -7.2 days; 95% CI -10 to -4.4 days). There were remarkable inconsistencies in how return to work as an outcome measure was examined in different RCTs.
  
  
  CONCLUSIONS
  Calculating standardised mean difference in future RCTs would allow future reviews to be more inclusive of the evidence. The authors suggest more consistent approach for evaluating work-related features in future studies. We recommend that new fit note categories introduced by UK Department of Work and Pension (unfit for all work/return to modified work or work adaptations/return to normal work) would be used to identify different levels of return to work.
authors.affiliation: Healthy Working Lives Group, Public Health and Health Policy Section, University of Glasgow, Glasgow, Scotland, UK. kavehasanati@doctors.org.uk
authors.forename: Kaveh A
authors.initials: KA
authors.lastname: Sanati
authors.forename: Massoud
authors.initials: M
authors.lastname: Mansouri
authors.forename: Duncan
authors.initials: D
authors.lastname: Macdonald
authors.forename: Shahab
authors.initials: S
authors.lastname: Ghafghazi
authors.forename: Ewan
authors.initials: E
authors.lastname: Macdonald
authors.forename: Ghasem
authors.initials: G
authors.lastname: Yadegarfar
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D020127:Recovery of Function; D013997:Time Factors