A Randomized Comparison of Double Small, Standard, and Endoscopic Approaches for Carpal Tunnel Release.

Abstract

The purpose of this study was to introduce a new surgical technique of carpal tunnel release through double small incisions, and to compare the technique with the standard open release and endoscopic release. Two hundred and seven patients were allocated randomly into group A (n = 73), B (n = 65), or C (n = 69). Patients in group A were treated with carpal tunnel release by means of double small incisions. Patients in group B were treated by means of the standard incision. Patients in group C had endoscopic release. Preoperatively, the mean severity of symptoms of groups A, B, and C was 3.7 ± 0.58, 3.8 ± 0.62, and 3.7 ± 0.52, respectively; and the mean functional status was 3.2 ± 0.71, 3.2 ± 0.71, and 3.5 ± 0.64, respectively. At the final follow-up of 3 years, the mean severity of symptoms of the groups was 1.2 ± 0.45, 1.2 ± 0.31, and 1.5 ± 0.36, respectively; and the mean functional status was 1.2 ± 0.38, 1.2 ± 0.41, and 1.5 ± 0.42, respectively. Patient satisfaction was 95 ± 4.2, 90 ± 5.8, and 93 ± 4.4, respectively. There were no significant differences between groups regarding symptom severity or function status (p > 0.05). For scar appearance, there were significant differences between groups A and B and between B and C, but not between A and C; for patient satisfaction, there were significant differences in all comparisons. Carpal tunnel release by means of double small incisions is a minimally invasive and less technically challenging procedure with good nerve visualization, resulting in good appearance of scars. Therapeutic, II.