title: Mini-open versus extended open release for severe carpal tunnel syndrome.
abstract: BACKGROUND
  This study aims to compare surgical outcomes of severe carpal tunnel syndrome (CTS) treated with mini-incision versus extensile release.
  
  
  METHODS
  The method employed in this study was a retrospective review of patients with severe CTS, defined by electrophysiologic studies showing non-recordable distal sensory latency of the median nerve. Patients underwent either a mini-incision (2 cm) release of the transverse carpal ligament (group 1) or extensile release proximal to the wrist flexion crease (group 2). Exclusion criteria included prior carpal tunnel release, use of muscle flap, multiple concurrent procedures, or a prior diagnosis of peripheral neuropathy. Group 1 included 70 wrists (40 females, 30 males). Group 2 included 64 wrists (35 females, 29 males). Reported outcomes included pre- and post-operative grip strength as well as Boston Carpal Tunnel Questionnaires (BCTQ).
  
  
  RESULTS
  Patients in group 1 had a 22.6 % increase in grip strength postoperatively (4.5 months ± 5.0), while patients in group 2 had a 59.3 % increase (10.0 months ± 6.9). BCTQ surveys from group 1 (n = 46) demonstrated a symptom severity score of 12.93 and functional status score of 9.39 at an average follow-up of 41.9 ± 10.6 months. Group 2 (n = 42) surveys demonstrated averages of 12.88 and 9.10 at 43.1 ± 11.6 months. One patient in the mini-incision cohort required revision surgery after 2 years, while no patient in the extended release cohort underwent revision.
  
  
  CONCLUSIONS
  No significant differences between the two procedures with regard to patient-rated symptom severity or functional status outcomes were found. Both techniques were demonstrated to be effective treatment options for severe CTS.
authors.affiliation: The Philadelphia Hand Center, P.C., Thomas Jefferson University, 834 Chestnut Street, Suite G114, Philadelphia, PA 19107 USA.
authors.forename: Praveen G
authors.initials: PG
authors.lastname: Murthy
authors.affiliation: The Philadelphia Hand Center, P.C., Thomas Jefferson University, 834 Chestnut Street, Suite G114, Philadelphia, PA 19107 USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Goljan
authors.affiliation: The Philadelphia Hand Center, P.C., Thomas Jefferson University, 834 Chestnut Street, Suite G114, Philadelphia, PA 19107 USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Mendez
authors.affiliation: The Philadelphia Hand Center, P.C., Thomas Jefferson University, 834 Chestnut Street, Suite G114, Philadelphia, PA 19107 USA.
authors.forename: Sidney M
authors.initials: SM
authors.lastname: Jacoby
authors.affiliation: The Philadelphia Hand Center, P.C., Thomas Jefferson University, 834 Chestnut Street, Suite G114, Philadelphia, PA 19107 USA.
authors.forename: Eon K
authors.initials: EK
authors.lastname: Shin
authors.affiliation: The Philadelphia Hand Center, P.C., Thomas Jefferson University, 834 Chestnut Street, Suite G114, Philadelphia, PA 19107 USA.
authors.forename: Arthur Lee
authors.initials: AL
authors.lastname: Osterman
keywords: Extensile release; Mini-incision; Outcomes; Severe carpal tunnel syndrome