Carpal tunnel release: a randomized comparison of three surgical methods

Larsen, Marthe; Sörensen, Allan Ibsen; Crone, K L; Weis, T.; Boeckstyns, Michel E. H.

doi:10.1177/1753193412475247

Cited by 83 publications

(77 citation statements)

References 14 publications

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“…The risk of nerve injury was increased in endoscopically treated patients (RR, 2.84 [1][2][3][4][5][6][7]; n = 1573; p = 0.03) [1,4,11,12,14,16,20,25,27,28,34,35,38,41,42,44] ( Fig. 6A), though the majority were temporary neurapraxias.…”

Section: Complicationsmentioning

confidence: 92%

“…The frequency-weighted followup for the included studies was 11 ± 14 months. The methodologic quality was excellent in two studies, good in five, and fair in 14, yielding a mean CONSORT score of 12.0 (range, [8][9][10][11][12][13][14][15][16][17][18][19][20][21]. A funnel plot (Fig.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…There were 16 and seven trial arms managed with standard [1-5, 10-12, 14, 16, 20, 25, 35, 38, 41, 42] and limited open carpal tunnel release [2,17,20,27,28,34,44], respectively. There were 11 and nine trial arms managed with single- [1,11,14,17,20,27,28,35,38,41,42] and double-portal [3-5, 10, 12, 16, 25, 34, 44] endoscopic carpal tunnel release, respectively, whereas one trial did not clearly specify the endoscopic technique [2]. [3,17,34,35,42] (Fig.…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…The methodologic quality of each included RCT was assessed using the 22-point Consolidated Standards Of Reporting Trials (CONSORT) checklist [36]. Studies were scored and classified as excellent (18)(19)(20)(21)(22), good (13)(14)(15)(16)(17), fair (8)(9)(10)(11)(12), or poor (B 7). A sensitivity analysis [21] was performed using only trials of excellent or good methodologic quality according to the CONSORT score to explore the possibility that consideration of lowerquality RCTs might unduly influence the findings of the main analyses.…”

Section: Data Synthesis and Statistical Analysismentioning

confidence: 99%

“…Our meta-analysis is the first, to our knowledge, to specifically examine pillar pain and ancillary endpoints like operative time and digital sensibility performance. Several randomized controlled trials (RCTs) also have been recently published [2,11,17,20].…”

mentioning

confidence: 98%

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Open versus Endoscopic Carpal Tunnel Release: A Meta-analysis of Randomized Controlled Trials

Sayegh

Strauch

2015

Clinical Orthopaedics &Amp; Related Research

186

173

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High-level evidence from randomized controlled trials indicates that endoscopic release allows earlier return to work and improved strength during the early postoperative period. Results at 6 months or later are similar according to current data except that patients undergoing endoscopic release are at greater risk of nerve injury and lower risk of scar tenderness compared with open release. While endoscopic release may appeal to patients who require an early return to work and activities, surgeons should be cognizant of its elevated incidence of transient nerve injury amid its similar overall efficacy to open carpal tunnel release. Additional research is required to define the learning curve of endoscopic release and clarify the influence of surgeon volume on its safety.

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Section: Complicationsmentioning

confidence: 92%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Patient Characteristicsmentioning

confidence: 99%

Section: Data Synthesis and Statistical Analysismentioning

confidence: 99%

mentioning

confidence: 98%

See 3 more Smart Citations

Open versus Endoscopic Carpal Tunnel Release: A Meta-analysis of Randomized Controlled Trials

Sayegh

Strauch

2015

Clinical Orthopaedics &Amp; Related Research

186

173

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Intraindividual comparison between open and endoscopic release in bilateral carpal tunnel syndrome: a meta‐analysis of randomized controlled trials

Zhang

2016

Brain and Behavior

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PurposeThis study evaluated functional outcomes and safety after endoscopic and open bilateral carpal tunnel syndrome release in opposite hands of the same patients through a meta‐analysis of randomized controlled trial data.Materials and MethodsRandomized controlled trials involving both methods in opposite hands of patients with bilateral carpal tunnel syndrome were identified via a systematic review of PUBMED and EMBASE.ResultsRelative risks (RRs) and 95% confidence intervals (CIs) from five randomized controlled trials involving 142 patients with bilateral carpal tunnel syndrome were calculated using fixed‐ or random‐effect methods, with a length of follow‐up from 24 to 52 weeks after surgery. Compared with open release, endoscopic carpal tunnel release was associated with significantly better Boston Carpal Tunnel Questionnaire functional status scores (mean difference [MD] = 0.13, 95% confidence interval [CI] [0.02 – 0.25]; P = 0.02), but not symptom severity scores (RR = 0.06, 95% CI [−0.15 to 0.04]; P = 0.25). Endoscopic release required a longer operative time, but the procedures did not differ significantly in visual analog scale pain scores (MD = 0.02, 95% CI [−0.08 to 0.11]; P = 0.75), handgrip strength (MD = 0.17, 95% CI [−2.03 to 2.37]; P = 0.88), digital sensibility static two‐point discrimination (MD = 0.34, 95% CI [−0.03 to 0.70]; P = 0.07), or complication rates (MD = 0.01, 95% CI [−0.02 to 0.05], P = 0.47).ConclusionFrom intraindividual evidence, endoscopic release promoted better recovery of daily life functions than open release, but required a longer operative time. The procedures provided similar symptom relief and hand strength and sensibility recovery, and were safe for patients with carpal tunnel syndrome.

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Carpal tunnel release: Safe and simple identification of the flexor retinaculum based on superficial anatomical landmarks

et al. 2017

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The aim of our study was to project the borders of the flexor retinaculum (FR) onto superficial landmarks since its insufficient splitting is the most common reason for persistence of symptoms after carpal tunnel release. In 60 hands the radial and ulnar styloid processes were linked by a horizontal line and a longitudinal line was laid through the ring finger's radial side. These were intersected resulting in the reference point "A" on the forearm. As the second basing point "B", the radial margin of the ring finger at the palmar digital crease was chosen. Measurement of the FR was carried out with regard to the reference points. The proximal margin of the FR was located at 4% of the reference line A-B starting from point A and extended up to 52% of this total length. Results indicate that splitting alongside the proximal half of line A-B divides the FR completely. Clin. Anat. 30:512-516, 2017. © 2017 Wiley Periodicals, Inc.

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Carpal tunnel release: a randomized comparison of three surgical methods

Cited by 83 publications

References 14 publications

Open versus Endoscopic Carpal Tunnel Release: A Meta-analysis of Randomized Controlled Trials

Open versus Endoscopic Carpal Tunnel Release: A Meta-analysis of Randomized Controlled Trials

Intraindividual comparison between open and endoscopic release in bilateral carpal tunnel syndrome: a meta‐analysis of randomized controlled trials

Carpal tunnel release: Safe and simple identification of the flexor retinaculum based on superficial anatomical landmarks

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