title: Prospective randomized comparison of single-incision and two-incision carpal tunnel release outcomes.
abstract: BACKGROUND
  This study analyzes both the subjective and objective symptom and functional outcomes of patients who underwent either traditional single-incision or two-incision carpal tunnel release (CTR).
  
  
  METHODS
  From 2008 to 2009, patients with isolated carpal tunnel syndrome were randomized to undergo either single-incision or two-incision CTR by a single surgeon at a university medical center. Pre-operatively, participants completed a Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire, Brigham and Women's Carpal Tunnel Questionnaire (BWCTQ), as well as grip and pinch strength and Semmes-Weinstein monofilament sensation testing. At 2 weeks, 6 weeks and at least 6 months post-operatively, these measurements were repeated along with assessment of scar tenderness and pillar pain. Data were analyzed using SPSS version 20 software to perform non-parametric tests and Pearson's correlations. Significance was set at p = 0.05.
  
  
  RESULTS
  There was no statistically significant difference between the single- and two-incision CTR groups with respect to pre- and post-operative DASH scores, BWCTQ scores, grip strength, pinch strength, scar tenderness, or pillar pain. The only statistically significant difference was improved sensation by Semmes-Weinstein in the single-incision group in the second finger at 6 weeks post-operatively and in the third finger at 6 months post-operatively.
  
  
  CONCLUSIONS
  The preservation of the superficial nerves and subcutaneous tissue between the thenar and hypothenar eminences may account for reports of less scar tenderness and pillar pain among recipients of two-incision CTR compared to single-incision CTR in the early post-operative period. However, there is similar post-operative recovery and improvement in grip and pinch strength and sensation after 6+ months post-operatively.
authors.affiliation: Department of Orthopaedic Surgery, Stanford University School of Medicine, Palo Alto, CA USA.
authors.forename: Tiffany N
authors.initials: TN
authors.lastname: Castillo
authors.affiliation: Department of Orthopaedic Surgery, Stanford University School of Medicine, Palo Alto, CA USA ; Department of Orthopaedic Surgery, Stanford University, 450 Broadway Street, Suite C442, Redwood City, CA 94063 USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Yao
keywords: Brigham and Women's Carpal Tunnel Questionnaire; Carpal tunnel release; Carpal tunnel syndrome; DASH Questionnaire; Minimally-invasive carpal tunnel release; Two-incision carpal tunnel release