title: Early versus delayed endoscopic surgery for carpal tunnel syndrome: prospective randomized study.
abstract: OBJECTIVE
  To compare the effects of early versus delayed endoscopic surgery in patients with moderately severe carpal tunnel syndrome (CTS).
  
  
  METHODS
  The study included 100 patients with CTS. Investigations performed before surgery excluded secondary causes. Patients with moderately severe CTS (grade 3-4) were randomly assigned. Bland's neurophysiologic grading scale for CTS was used to assess the patients. Patients underwent an endoscopic carpal tunnel release using an indigenously designed instrument.
  
  
  RESULTS
  Following a course of conservative treatment, surgical treatment was offered in two groups: early surgery (n = 51; <1 week after diagnosis) and delayed surgery as per the usual waiting list (n = 49; >6 months after diagnosis). Improvement in both groups was significant (P < 0.001). When both groups were compared, improvement was better for the early surgery group (P < 0.001; confidence interval 6.35-9.12).
  
  
  CONCLUSIONS
  On the basis of this study, early endoscopic surgery is proposed in patients with moderately severe CTS.
authors.affiliation: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: P Sarat
authors.initials: PS
authors.lastname: Chandra
authors.forename: Pankaj Kumar
authors.initials: PK
authors.lastname: Singh
authors.forename: Vinay
authors.initials: V
authors.lastname: Goyal
authors.forename: Avnish Kumar
authors.initials: AK
authors.lastname: Chauhan
authors.forename: Nirmal
authors.initials: N
authors.lastname: Thakkur
authors.forename: Manjari
authors.initials: M
authors.lastname: Tripathi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000601:surgery*; D061345:Early Medical Intervention / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D017060:Patient Satisfaction; D011446:Prospective Studies; D014850:Waiting Lists; D055815:Young Adult