Effectiveness of mini-open carpal tunnel release: An outcome study

Abstract

Background Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy with a high morbidity and healthcare-related costs. Currently there is no consensus about the best treatment option. The purpose of this prospective cohort study conducted at a single institution was to evaluate the clinical outcomes and patient satisfaction following a mini-open carpal tunnel release for idiopathic CTS. Methods A total of 72 patients (53 female and 19 male patients; mean age, 57.8±15.3 years; range, 24–94 years) had a mini-open carpal tunnel release performed by a single senior surgeon between June 2015 and June 2016. The patients were evaluated preoperatively, and at 3 and 12 months post-intervention. At every follow-up, the Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) and visual analogue scale (VAS) scores for pain and satisfaction were completed. Digital sensibility (using Semmes- Weinstein monofilaments) was assessed and pinch and grip strengths were measured. Results Statistically significant and clinically relevant improvement was found in terms of digital sensibility, grip and pinch strength (except for 2-point pinch), BCTSQ scores and pain scores. The complication rate was minimal, and no major complications occurred. Two patients experienced recurrence. The availability of follow-up records (including patient-reported outcomes, BCTSQ and VAS scores, and the complication rate) at 1-year post-intervention varied between 69% and 74% (50–53 patients) depending on which parameter was assessed. Patient satisfaction was high (mean, 80.9±26.0; range, 0–100). Conclusions This study demonstrates that mini-incision carpal tunnel release is clinically effective in the short and long term.

Open carpal release using local anesthesia without a tourniquet: Does bleeding tendency affect the outcome?

“…Studies investigating open or endoscopic release of the carpal tunnel have reported advantages and disadvantages of each technique, and it is up to the surgeon to decide the surgical method 10 11 12 13 . Carpal tunnel release through a small incision, in which the TCL is incised through a minimal skin incision, alleviates the side effects and challenges of endoscopic decompression.…”

The Relevance of Collision Tests and Quantitative Sensory Testing in Diagnostics and Postoperative Outcome Prediction in Carpal Tunnel Syndrome

“…Surgical intervention is a well-known and effective method of CTS treatment. Different surgical methods are considered: open, mini-open, and endoscopic decompression of the median nerve at the wrist ( 1 , 21 , 22 ). In all our patients, an open, minimally invasive method was performed, with a surgical incision above the flexor cord or on the level of the metacarpus with immediate neuromobilization and fitness exercises after the operation.…”

“…However, endoscopic surgery potentially increases the risk of damage to the motor branch of the median nerve, and therefore most hand surgeons choose the open method. According to van den Broeke et al ( 22 ), the mini-open method probably needs a longer time for a good outcome than the standard period of 3 to 6 months and is normally characterized by persistent post-intervention complaints. Some reports consider the endoscopic technique to be better in terms of pain relief and patient satisfaction in the early postoperative period.…”

Anatomical variations of the innervated radial artery superficial palmar branch flap: A series of 28 clinical cases

“…Only one of the 28 cases involved a prominent, thick LABC. Increased attention is needed during nerve dissection, such as open and endoscopic carpal tunnel release [21,22], Camitz opponensplasty, or elevation of an iRASP flap. A neglected injury to the deep branch of the PCMN or the LABC is likely to cause discomfort.…”