A Randomized Controlled Trial of Knifelight and Open Carpal Tunnel Release

Abstract

A randomized controlled trial was done to compare the results of carpal tunnel decompression using the standard open approach and the Knifelight technique. Twenty-six patients with bilateral carpal tunnel syndrome requiring operation were selected for the study and the operative technique was randomized for the first hand. Six weeks later, the second hand was operated upon using the alternate technique. There was little difference between the two techniques with regard to time taken to return to work, return of grip strength, symptom relief, complications, incidence of pillar pain and patient preference. However, the incidence of scar tenderness was significantly lower with the Knifelight technique.

Intraindividual comparison between open and endoscopic release in bilateral carpal tunnel syndrome: a meta‐analysis of randomized controlled trials

“…Although the standard OCTR technique is known to be effective and safe, ECTR was developed to reduce the incision size and time required for recovery (Brown et al 1993). Despite considerable efforts to determine a superior technique, discussion remains regarding whether the benefits of reduced daily life impairments associated with endoscopic carpal tunnel surgery outweigh the drawbacks of relative technical difficulty, cost-effectiveness, time requirements, and potential risks of iatrogenic injury to neurovascular structures (Jacobsen and Rahme 1996;Chung et al 1998;Bhattacharya et al 2004;Cresswell et al 2008;Atroshi et al 2009). Our meta-analysis included data from five randomized controlled trials involving a total of 142 patients with bilateral CTS.…”

The Effect of NeuroGen<sup>®</sup> Nerve Support Supplement on Pillar Pain after Endoscopic Carpal Tunnel Release

“…The discomfort in the palm is often the limiting factor in the patient's ability to resume normal activity and work. The endoscopic technique has demonstrated less pain than the traditional open method [2,6,[10][11][12][13][14][15][16][17]. Despite these improved results with the endoscopic technique, patients still have some degree of palm pain after surgery limiting return to activity.…”

Minimally invasive ultrasound‐guided carpal tunnel release: A cadaver study

“…16 To reduce these potential complications, less aggressive surgical interventions by means of minimal longitudinal or transverse incisions, including techniques under endoscopic control, have been developed. 16,24,25 MI-CTR, which is considered a ''blind'' technique, requires the precise identification of the anatomic landmarks to insure greater safety. [18][19][20] Nevertheless, the cost of the equipment, the cost of the procedure itself, and the prolonged learning curve necessary to master this technique are limitations to its use.…”

“…It utilizes a luminous scalpel and special retractors. 16,24,25 MI-CTR, which is considered a ''blind'' technique, requires the precise identification of the anatomic landmarks to insure greater safety. 26 MI-CTR does not allow the identification of anatomic variations (aberrant positions of the palmar branch and thenar muscular branch of the median nerve, presence of a bifid median nerve, persistent median artery, or variations of the ulnar artery) that can influence the surgical result.…”