A Randomized Comparison of Double Small, Standard, and Endoscopic Approaches for Carpal Tunnel Release

Zhang, Xu; Huang, Xingyi; Wang, Xianhui; Wen, Shumin; Sun, Jiayuan; Shao, Xinzhong

doi:10.1097/prs.0000000000002511

Cited by 21 publications

(39 citation statements)

References 28 publications

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“…5) (24,32,33), and BCTQ-F score at 1 year post-surgery (MD, 0.17; 95% CI, -0.02 to 0.36; P = 0.08; n = 592; random-effects model, with a heterogeneity of I 2 = 91%; P < 0.00001; Fig. 6) (24,32,33) between the ECTR and OCTR groups. Similarly, there were no differences in digital sensation, including the Semmes-Weinstein monofilament test score at 3 months post-surgery (MD, 0.06; 95% CI, -0.09 to 0.21; P = 0.43; n = 297; fixed-effects model, with a heterogeneity of I 2 = 0%; P = 0.65; Fig.…”

Section: Meta-analysis Resultsmentioning

confidence: 98%

“…7) (9,31) and Two-point Discrimination test score at 1 year post-surgery (MD, -0.16; 95% CI, -0.45 to 0.12; P = 0.26; n = 402; fixed-effects model, with a heterogeneity of I 2 = 35%; P = 0.20; Fig. 8) (29,33,34), between the two groups.…”

Section: Meta-analysis Resultsmentioning

confidence: 99%

“…4) (9,31), BCTQ-S score at 1 year post-surgery (MD, 0.15; 95% CI, -0.04 to 0.35; P = 0.13; n = 592; random-effects model, with a heterogeneity of I 2 = 92%; P < 0.00001; Fig. 5) (24,32,33), and BCTQ-F score at 1 year post-surgery (MD, 0.17; 95% CI, -0.02 to 0.36; P = 0.08; n = 592; random-effects model, with a heterogeneity of I 2 = 91%; P < 0.00001; Fig. 6) (24,32,33) between the ECTR and OCTR groups.…”

Section: Meta-analysis Resultsmentioning

confidence: 99%

“…The overall level of satisfaction with the outcome was based on a scale of 0 to 100 points. Two articles provided comparative data on the satisfaction rate (31,33). A portion of the data from Zhang et al (33) reported a satisfaction rate of up to 90%, with high heterogeneity; therefore, some of the satisfaction data from that study were excluded from the present meta-analysis.…”

Section: Satisfaction Ratementioning

confidence: 99%

“…Two articles provided comparative data on the satisfaction rate (31,33). A portion of the data from Zhang et al (33) reported a satisfaction rate of up to 90%, with high heterogeneity; therefore, some of the satisfaction data from that study were excluded from the present meta-analysis. The pooled data of the two articles showed that the satisfaction rate in the ECTR group was significantly higher than that in the OCTR group (MD, 3.13; 95% CI, 1.43 to 4.82; P = 0.0003; n = 303; fixed-effects model, with a heterogeneity of I 2 = 0%; P = 0.57) (31,33), and the clinical heterogeneity I 2 was null ( Fig.…”

Section: Satisfaction Ratementioning

confidence: 99%

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Open versus endoscopic carpal tunnel release: A systematic review and meta-analysis of randomized controlled trials

Luo

et al. 2020

Preprint

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Background Endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR) both have advantages and disadvantages for the treatment of carpal tunnel syndrome (CTS). We compared the effectiveness and safety of ECTR and OCTR based on evidence from a high-level randomized controlled trial. MethodsWe comprehensively searched PubMed, EMBASE, Cochrane Library, Web of Science, and Medline to identify relevant articles published until August 2019. Data regarding operative time, grip strength, Boston Carpal Tunnel Questionnaire scores, digital sensation, patient satisfaction, key pinch strength, return to work time, and complications were extracted and compared. All mean differences (MD) and odds ratios (OR) were expressed as ECTR relative to OCTR. Results Twenty-eight studies were included in our meta-analysis. ECTR was associated with significantly higher satisfaction rates (MD, 3.13; 95% confidence interval [CI], 1.43 to 4.82; P = 0.0003), greater key pinch strengths (MD, 0.79 kg; 95% CI, 0.27 to 1.32; P = 0.003), earlier return to work times (MD, -7.25 days; 95% CI, -14.31 to -0.19; P = 0.04), higher transient nerve injury rates (OR, 4.87; 95% CI, 1.37 to 17.25; P = 0.01), and a lower incidence of scar-related complications (OR, 0.20; 95% CI, 0.07 to 0.59; P = 0.004). There were no significant differences between the two methods in terms of permanent nerve injury (OR, 1.93; 95% CI, 0.58 to 6.40; P = 0.28). Conclusions Overall, evidence from randomized controlled trials indicates that ECTR results in better recovery of daily life functions than OCTR, as revealed by higher satisfaction rates, greater key pinch strengths, earlier return to work times, and fewer scar-related complications. Our findings suggest that patients with CTS can be effectively managed with ECTR.

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