Comparison of carpal tunnel release with three different techniques

Aslani, Hamidreza; Alizadeh, Khalil; Eajazi, Alireza; Karimi, Amin; Karimi, Mohammad; Zohreh, Zaferani; Khameneh, Seyed Mehdi Hosseini

doi:10.1016/j.clineuro.2012.02.017

Cited by 66 publications

(71 citation statements)

References 9 publications

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“…Preoperative clinical evaluation and postoperative follow-up were performed using the BCTSQ, evaluating the "quintet symptoms" (wrist pain, night pain, numbness, stiffness, and weakness). 2 Preoperative wrist pain, night pain, and numbness were the most troublesome symptoms in our patients' opinion, and they showed the highest prevalence. After surgical treatment, clinical improvement was obtained in both groups, but with several differences.…”

Section: Resultsmentioning

confidence: 99%

The double tunnels technique: an alternative minimally invasive approach for carpal tunnel syndrome

Vanni

Sirabella

Galzio

et al. 2015

JNS

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OBJECT The purpose of this study was to assess the effectiveness and safety of an alternative minimally invasive technique for the treatment of carpal tunnel syndrome (CTS). METHODS This was designed as a prospective, randomized, open-label, blinded end point evaluation (PROBE) study. The active comparison was double tunnels technique (DTT) (Group A, 110 patients) versus standard open decompression of the median nerve (control [Group B], 110 patients). Patient recruitment started in January 2011. The primary outcomes were the functional Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) scores and visual analog scale (VAS) scores for pain (pVAS) at Weeks 2 and 4, and at Months 3, 6, and 12. The secondary outcome was the aesthetics (aVAS) score at Weeks 2 and 4, and at Months 3, 6, and 12. RESULTS The Student t-test and ANOVA were used, and the results were considered statistically significant if the p value was ≤ 0.05 for continuous variables. The DTT is a tissue-sparing approach that allows the surgeon to limit the length of the incision (0.6 ± 0.05 cm) and to respect the palmar fascia and the subcutaneous tissue. Recovery from wrist pain, night pain, numbness, stiffness, and weakness was achieved more effectively and quickly compared with the standard approach. Better BCTSQ, pVAS, and aVAS scores were observed in Group A. CONCLUSIONS The DTT is a safe and effective approach for the treatment of CTS. This technique entails faster recovery times, better aesthetic outcomes, and lower risks of complications.

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Section: Resultsmentioning

confidence: 99%

The double tunnels technique: an alternative minimally invasive approach for carpal tunnel syndrome

Vanni

Sirabella

Galzio

et al. 2015

JNS

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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%

“…6A), though the majority were temporary neurapraxias. (MD, À9 days [À13 to À5]; n = 1234; p \ 0.001) [1,2,4,5,12,16,20,28,35,41,42] (Fig. 7).…”

Section: Complicationsmentioning

confidence: 96%

“…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%

“…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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