title: The effect of epineurotomy on the median nerve volume after the carpal tunnel release: a prospective randomised double-blind controlled trial.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the effects of epineurotomy on the post-surgical median nerve volume and clinical outcomes in carpal tunnel syndrome (CTS) patients with a prominent nerve narrowing.
  
  
  METHODS
  This was a prospective, randomised, double-blind controlled trial. Patients (n = 50) were randomised (1:1) to open-field surgical carpal tunnel release followed by a longitudinal epineurotomy of the nerve (test), or to open-field release without epineurotomy (control).
  
  
  RESULTS
  The nerve volume was slightly larger in the test group 90 days post-surgery (by 10.5 %, p = 0.157) but not 180 days post-surgery. No relevant electropyhsiological or clinical difference between groups and no effect of the nerve volume was observed. The subjective pain reduction was slightly more prominent in the control group at 180 days. Larger post-surgical nerve volume was associated with lower pain, but only in the control group.
  
  
  CONCLUSIONS
  Even in selected CTS patients, longitudinal epineurotomy confers no benefit regarding the nerve volume or clinical outcomes over a simple carpal tunnel release.
authors.affiliation: Department of Orthopaedic Surgery, County General Hospital Požega, Osječka 107, 34000 Požega, Croatia. tomislav_crnkovic@inet.hr
authors.forename: Tomislav
authors.initials: T
authors.lastname: Crnković
authors.forename: Ranko
authors.initials: R
authors.lastname: Bilić
authors.forename: Vladimir
authors.initials: V
authors.lastname: Trkulja
authors.forename: Marijan
authors.initials: M
authors.lastname: Cesarik
authors.forename: Nikola
authors.initials: N
authors.lastname: Gotovac
authors.forename: Robert
authors.initials: R
authors.lastname: Kolundžić
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000473:pathology / Q000601:surgery*; D004311:Double-Blind Method; D004576:Electromyography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000473:pathology / Q000502:physiology / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D010146:Pain; D010147:Pain Measurement; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies