Endoscopic versus open carpal tunnel release: Clinical results

Kerr, Charles; Gittins, Mark E.; Sybert, Daryl R.

doi:10.1016/s0749-8063(05)80109-4

Cited by 63 publications

(33 citation statements)

References 8 publications

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“…When a comparison was made by type of insurance reimbursement, patients who received WC required longer to recuperate and were more likely to require therapy than those who did not (7,9,10,(12)(13)(14)(15)(16)(17). Ninety-seven per cent of our short incision OHIP patients (171 of 177 hands) resumed ADL within 28 days.…”

Section: Resultsmentioning

confidence: 93%

“…Seventy-eight per cent of our short incision WC population (32 of 41 hands) resumed ADL within the 28-day period. Other studies reported a range of 33% to 63% within 28 days (7,8,14), a mean of 29.2 to 57.6 days (7,9,10,14,15) or a median of 57 to 71 days (12,14). The above studies were conducted in the United States, where many authors suspect that secondary gain is a factor in the recovery of WC patients (12,13,16,17).…”

Section: Resultsmentioning

confidence: 96%

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Open carpal tunnel release: Comparison of a long versus short incision

Kruger¹,

Rebot²

1998

CAN J PLAST SURG

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A review of our patients who had been treated with open carpal tunnel release (OCTR) undertaken in 1991 revealed that 78% had an uneventful course of recovery, resuming full function within two to four weeks, and that 25% required out-patient rehabilitation due to the persistence and magnitude of their symptoms three to four weeks postoperatively. Resumption of activities of daily living (ADL) was delayed by weakness, peri-incisional tenderness, restricted range of movement and swelling.In an effort to decrease postoperative morbidity and shorten recovery time, our surgical protocol was re-examined. Decreased postoperative discomfort and shorter recovery A total of 225 adults with carpal tunnel release of 313 wrists were studied to compare the outcome of a long (at least 3.5 cm) with that of a short (2.0 cm or less) incision technique. The two groups were compared for postoperative complaints, length of time until full function was regained, rate of referral to rehabilitation and the effect of Workers' Compensation status. The surgical technique and rehabilitation protocol are described. The number and severity of postoperative complaints were significantly reduced in the short incision group. In the non-Workers' Compensation group, 96% of short incision patients resumed full function within 28 days. This finding compares favourably with published results for endoscopic release, and is superior to results obtained with the long incision. Workers' Compensation patients required longer to recuperate, with 78% regaining full function within 28 days. Of those with Workers' Compensation, 47% of the long incision group and 27% of the short incision group required out-patient therapy. For the non-Workers' Compensation group, this percentage decreased to 21% of those with the long incision and 3% with the short incision. A history of vocational or avocational repetitive motion patterns was the most common indicator for therapy and accounted for 67% of rehabilitation referrals. Key Words: Adult, Carpal tunnel release, Median nerve, Occupational therapy, Physical therapy, Treatment outcomeDégagement ouvert du canal carpien : comparaison d'une incision longue versus courte RÉSUMÉ : En tout, 225 adultes ayant subi un dégagement du canal carpien, totalisant 313 poignets, ont été étudiés afin de comparer les résultats d'une technique d'incision longue (au moins 3,5 cm) versus courte (2,0 cm ou moins). Les deux groupes ont été comparés au chapitre des plaintes postopératoires, du temps de retour à un fonctionnement normal, du taux de demandes auprès des programmes de réadaptation et de l'effet sur la compensation par la CSST. La technique chirurgicale et le protocole de réadaptation sont décrits. Le nombre et la gravité des problèmes postopératoires ont été significativement moindres dans le groupe ayant subi l'incision courte. Pour le groupe non inscrit à la CSST, 96 % des patients ayant subi une incision courte ont retrouvé un fonctionnement normal en 28 jours. Ces résultats se comparent favorablement aux résultats publiés a...

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 96%

Open carpal tunnel release: Comparison of a long versus short incision

Kruger¹,

Rebot²

1998

CAN J PLAST SURG

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“…Of the ineligible studies, 11 were excluded because they were not randomized (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33), four because they did not compare ECTR with OCTR (34-37) and two because RTW was not an outcome measure (38)(39).…”

Section: Resultsmentioning

confidence: 99%

Analysis of reporting return to work in studies comparing open with endoscopic carpal tunnel release: A review of randomized controlled trials

Ayeni¹,

Thoma²

2005

CAN J PLAST SURG

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BACKGROUND:In studies comparing open with endoscopic carpal tunnel release, return to work (RTW) is often cited as a primary outcome. OBJECTIVE: The present study assessed the reporting of RTW and evaluated its usefulness in studies comparing these two methods of carpal tunnel release. METHODS: A computerized search was conducted to find randomized controlled trials that compared open with endoscopic carpal tunnel release, with RTW as an outcome measure. The factors that were compared across the studies included definition of RTW, units quantifying RTW, measures of hand function, patients' type of employment, worker's compensation or insurance status, patients' handedness, unilateral or bilateral carpal tunnel release, and use of rehabilitation. RESULTS: Fifteen studies met the inclusion criteria for the present systematic review. Of the 15 studies reviewed, there were seven definitions of RTW. All studies defined whether the patients underwent unilateral or bilateral carpal tunnel release but there was variability in the calculation of RTW when bilateral releases were performed. The impact of worker's compensation or insurance, type of work, handedness and rehabilitation were inconsistently addressed as factors affecting RTW. CONCLUSIONS: Although RTW ideally reflects function and recovery, it is inadequately measured and reported. The present review revealed that, in studies comparing open carpal tunnel release with endoscopic carpal tunnel release, there is lack of uniformity in reporting RTW, which may contribute to the inconclusive results for RTW. Future research needs to ensure that RTW is used in a consistent manner.

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“…Similar to the present study in which the time to return to work for the patients ranged from 7 to 35 days (mean, 15 days), Nagle et al reported that 81% of the non-worker's compensation patients returned to work less than 4 weeks after the procedure 6 . Kerr et al found that patients treated endoscopically irrespective of insurance class, returned to work 10.6 days sooner than did those treated by open method 4 .…”

Section: Discussionmentioning

confidence: 99%

“…Major controversy has ensued in the literature, however, regarding the safety, success, and, most importantly, the complication rate of this procedure. Comparative clinical studies have shown that endoscopic carpal tunnel release resulted in less postoperative pain, faster recovery of grip and pinch strength, and earlier return to work compared to open methods [3][4] . Palmer DH et al 5 reported a single centre prospective study that compared three different treatment methods: standard open release, single-portal endoscopic technique (Agee), and the two-portal endoscopic technique (Chow).…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Carpal Tunnel Release – A Prospective Study of Functional Outcome

Thuraisingham¹,

Ahmad²,

Loh³

2009

MOJ

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To evaluate the functional outcome of patients who underwent endoscopic carpal tunnel release (ECTR). This was a prospective study in 24 patients with idiopathic carpal tunnel syndrome undergoing ECTR . Patient assessment entailing both subjective and objective tests at intervals of two and six weeks, three, six and nine months and finally at one year postoperatively. Our assessment results showed overall improvement in symptoms. As early as two weeks post-operatively, there was a low incidence of pillar pain and scar tenderness, allowing patients to return to work early. There were no serious complications. ECTR can be effectively performed with a low perioperative and late postoperative rate of complications. This minimally invasive method can be an option of surgical treatment for patients with carpal tunnel syndrome, who intend to return to work soon after surgery.

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Endoscopic versus open carpal tunnel release: Clinical results

Cited by 63 publications

References 8 publications

Open carpal tunnel release: Comparison of a long versus short incision

Open carpal tunnel release: Comparison of a long versus short incision

Analysis of reporting return to work in studies comparing open with endoscopic carpal tunnel release: A review of randomized controlled trials

Endoscopic Carpal Tunnel Release – A Prospective Study of Functional Outcome

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