A Randomized Clinical Trialith an incidence of 1 to 3 cases and a prevalence of 50 cases per 1000 person-years, carpal tunnel syndrome is the most diagnosed entrapment neuropathy. 1,2 A course of nonsurgical treatment, is an option in carpal tunnel syndrome. When nonsurgical treatment fails to resolve the symptoms, surgery is considered a valid option. Carpal tunnel release can be considered as a first effective option if there is denervation or the patient elects surgery. 1,3-5 When comparing carpal tunnel release techniques with different incision lengths, smaller incisions show a faster return to work, better cosmetic results, 6,7 and lower pain rates. 4,[8][9][10][11][12] Incision sizes Jose Manuel Rojo-Manaute, MD, PhD, Alberto Capa-Grasa, MD, PhD, Francisco Chana-Rodríguez, MD, PhD, Ruben Perez-Mañanes, MD, PhD, Guillermo Rodriguez-Maruri, MD, Pablo Sanz-Ruiz, MD, PhD, Jorge Muñoz-Ledesma, MD, Mikel Aburto-Bernardo, MD, Luis Esparragoza-Cabrera, MD, Miguel del Cerro-Gutiérrez, MD, PhD, Javier Vaquero-Martín, MD, PhD Received July 2, 2015, ORIGINAL RESEARCHObjectives-The purpose of this study was to compare the outcomes of 1-mm ultraminimally invasive ultrasound-guided carpal tunnel release and 2-cm blind mini-open carpal tunnel release.Methods-We conducted a single-center individual parallel-group controlled-superiority randomized control trial in an ambulatory office-based setting at a third-level referral hospital. Eligible participants had clinical signs of primary carpal tunnel syndrome and positive electrodiagnostic test results and were followed for 12 months. Independent outcome assessors were blinded. Patients were randomized by concealed allocation (1:1) by an independent blocked computer-generated list. The postoperative score on the Quick-Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire was the primary variable. Grip strength and time for discontinuation of oral analgesics, complete wrist flexion-extension, relief of paresthesia, and return to normal daily activities (including work) were assessed. Conclusions-Ultra-minimally invasive carpal tunnel release provides earlier functional return and less postoperative morbidity with the same neurologic recovery as mini-open carpal tunnel release for patients with symptomatic primary carpal tunnel syndrome.

Purpose The aim of our study is to report our complication rate and analyze the associated risk factors when removing cannulated stainless steel screws for SCFE fixation. Methods This was a multicenter retrospective study of patients who underwent removal of cannulated stainless steel screws after a mean time of 2.03 years of implantation. Thirty-two patients were included (38 hips) with a mean of 13.7 years of age during screw removal surgery.The mean post-removal follow up time was 1.6 years. In all cases the removal of screws was done systematically. Demographic data, possible risk factors related to removal failure, as well as post-removal complications such as postremoval fractures, infections and scar issues were recorded. Results A removal failure rate of 15.79 % (6/38) was found. The removal surgical time was longer than the initial fixation time but without statistical significance (70.78 vs 61.84 m, p = 0.196). However, the duration of screw implantation (r 2 : 7.09; IC: 1.12-13.06) and screw head bony coverage (r 2 : 21.32; IC: 5.58-37.06) were both related to this prolonged time. Multivariant analysis revealed that a fully threaded cannulated screw had the lowest removal failure risk (OR: 0.3; IC: 0.14-0.61). There were no postremoval complications recorded. Conclusions We recommend to use full threaded cannulated stainless steel screws and to perform the procedure as soon as the physis are closed to decrease the surgical time. It is a safe procedure based on a low rate of complications such as post-removal fractures, infection and scar issues.