Self-Reliance and Postoperative Hand Recovery After Simultaneous, Bilateral Endoscopic Carpal Tunnel Release: A Prospective Study

Endoscopic carpal surgery in carpal tunnel syndrome: A systematic review

“…Two studies were RCT studies by Kempton et al 18 and Truelove et al 19 . Seven studies were prospective studies, the most prevalent research design, including studies by Degeorge et al, 20 Li et al, 21 Trung et al, 22 Grandizio et al, 23 Ng et al, 24 , 25 and Rooij et al 26 Only five retrospective studies were identified, by Satteson et al, 27 Hein et al, 28 Liu and Wu, 29 Wellington et al, 30 and Tarfusser et al 31 …”

“… 33 Clinical and functional outcomes included the visual analog scale (VAS), 34 , 35 Quick Disabilities of the Arm, Shoulder, and Hand (DASH) score, 36 Activities of Daily Living (ADL) scale, 37 the DASH score, 38 pinch and grip strength, 39 , 40 two-point discrimination, 41 , 42 and the number of days until self-reliance. 26 Secondary outcomes included imaging and postoperative investigations: motor NCSs, sensory nerve conduction velocities (SNCV) and sensory nerve action potential (SNAPS), cross-sectional area (CSA), edema length (EL), anteroposterior diameter of median nerve (D), as well as median nerve CSA, width, height, TCL width, and anteroposterior dimension of the carpal tunnel. Some studies evaluated surgical timing using a five-point scoring system based on a written multiple-choice test, for example, Wellington et al 30 and Kempton et al 18 …”

“…Degeorge et al, 20 Trung et al, 22 and Grandizio et al 23 demonstrated the Agee technique in a single-portal endoscopic technique which incised the wrist crease from proximal to distal and then inserted a clear plastic cannula with an angled endoscope. Van Rooij et al 26 following Fechner et al (2013) 44 used a single-portal technique, claiming that it will can better prevent accidental injury to the median nerve . Liu and Wu 29 used a new technique using a plastic shield created from a standard syringe that offers a 360° view of the carpal tunnel and provides protection for the median nerve in single-portal endoscopic techniques.…”

“…Another single-portal technique used in the study by van Rooij et al 26 which employed the technique described by Fechner et al (2013) 44 and stated that postoperative functional status increased significantly on a daily basis, and that the mean BCTQ score decreased gradually from intense difficulty to little difficulty in daily tasks over a period of 7 days. Tarfusser et al 31 using another single-portal via transretinacular technique stated that all patients reported rapid recovery, pain subsidence, and return to daily activity within a few days, although one patient did not experience measurable improvement of grip strength or sensory function, but only disappearance of pain and discomfort at 2 weeks after surgery.…”

“…Among the studies that satisfied the inclusion requirements, six studies investigated imaging parameters at short-term follow-up, whereas eight studies analyzed pain and function as a primary endpoint. The majority of studies used the BCTQ for evaluation, and they found short-term pain reduction after ECTR at intervals of between 1 day and 2 weeks (van Rooij et al 26 ; Tarfusser et al 31 ; Liu and Wu 29 ; Trung et al 22 ; Degeorge et al 20 ). Several studies additionally reported imaging parameters at long-term follow-up ranging from 2 weeks to 6 years (Grandizio et al 23 ; Ng et al 24 , 25 ).…”