Similar effectiveness of the open versus endoscopic technique for carpal tunnel syndrome: a prospective randomized trial

Abstract

This prospective randomized study aims at evaluating the electrophysiological results of endoscopic and open carpal ligament release in patients with carpal tunnel syndrome. Included in the study were 41 patients diagnosed with carpal tunnel syndrome (21 hands in the endoscopic group and 20 hands in the open group). The Boston questionnaire was administered preoperatively and postoperatively to the patients, and their functional capacities and symptom severities were recorded. Physical examination was carried out preoperatively and in the postoperative sixth month. Demographic data and preoperative Boston symptomatic and functional scores were similar between both groups. A significant improvement was obtained in the Boston symptomatic and functional scores of both groups, but no significant difference was found between the groups in terms of improvement in the symptomatic and the functional scores. A significant shortening in median nerve motor distal latency and an increase in the velocity of sensory conductions were determined in both groups in the postoperative electromyography, but no difference was found between them in terms of improvement in the electromyography values. It was shown both clinically and electrophysiologically that endoscopic carpal tunnel surgery was as effective as open surgery as a treatment method for carpal tunnel syndrome.

Endoscopic carpal tunnel release surgery: a case study in Vietnam

“…This difference is statistically significant at p < 0.05. These results are similar to those in [8–11, 20, 27–31].…”

“…Kang (2013) noted that 34 (65%) out of 52 patients, who underwent bilateral decompression (with minimally invasive and endoscopic approaches), would prefer endoscopic surgery [25]. Many authors describe a low recurrence rate and faster recovery after endoscopic decompression of the median nerve [8–11]. Sayegh and Strauch described the long-term effect from open and endoscopic decompression.…”

“…The carpal tunnel release (CTR) surgery, in which the surgeon cuts the transverse carpal ligament, is the most radical treatment, assigned in moderate and severe CTS (stages 2 and 3 by R. Szabo [7]) or when non-operative treatment fails [5]. In Vietnam, open surgery is a common treatment for CTS that had been in use for years, while the endoscopic surgery is an innovation with many advantages (esthetically small scar surgery on wrist, painlessness and faster recovery time) [8–11]. The endoscopic carpal tunnel decompression of the median nerve is a common world practice now.…”

Comparison of open and endoscopic carpal tunnel surgery regarding clinical outcomes, complication and return to daily life: A prospective comparative study

“…Many studies have investigated the outcomes of open and endoscopic carpal tunnel release 12. Sayegh et al13 published a meta-analysis of good-quality randomized controlled clinical trials comparing the two techniques and they concluded that symptom relief, severity, and functional status were similar for both techniques; however, patients who underwent endoscopic surgery had earlier return of grip and pinch strength.…”

Surgery of True Recurring Median Carpal Tunnel Syndrome with Synovial Flap by Wulle Plus Integument Enlargement Leads to a High Patient’s Satisfaction and Improved Functionality

“…In the literature, large series of nerve releases to treat median carpal tunnel syndrome (CTS) show a complication rate [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] (treatment failure) that varies from 3 to 25% and a reoperating rate of 12% [3,[7][8][9][10][11]17]. Additionally, multiple neurolysis (external or internal) alone is rarely the appropriate treatment for true recurring carpal tunnel syndrome, because the re-operated nerve is often trapped in fibrous scar tissue resulting from the repeated disintegration of the surrounding gliding tissue [1,7,[18][19][20][21].…”