Comparison of Wrist Arthroscopy, Small Incision Surgery, and Conventional Surgery for the Treatment of Carpal Tunnel Syndrome: A Retrospective Study at a Single Center

Abstract

Background This study aimed to compare the efficacy and safety of wrist arthroscopy, small incision surgery, and conventional open carpal tunnel release surgery for the treatment of carpal tunnel syndrome. Material/Methods Patients with carpal tunnel syndrome (n=111) were treated with wrist arthroscopy (n=33), small incision surgery (n=40), and conventional open carpal tunnel release surgery (n=38). Incision length, duration of surgery, degree of intraoperative bleeding, recovery time, and findings at postoperative follow-up at one month, three months, and six months after surgery were recorded. Assessment included the two-point discrimination test, the grip and pinch strength test, the visual analog scale (VAS) score for pain, the Levine questionnaire, and Kelly’s therapeutic evaluation. Results Incision length, duration of surgery, intraoperative bleeding, and recovery time were significantly reduced in the wrist arthroscopy group and the small incision surgery group compared with the conventional surgery group (p<0.05). There were no significant differences in the two-point discrimination or grip and pinch strength test (p>0.05). Postoperatively, at one month, the VAS score, Levine score, and Kelly’s therapeutic evaluation in the wrist arthroscopy group and the small incision surgery group were significantly lower compared with the conventional surgery group (p<0.05). Scar length and scar tenderness in the conventional surgery group were significantly increased compared with the wrist arthroscopy group and the small incision surgery group (p<0.05). Conclusions Wrist arthroscopy, small incision surgery, and conventional open carpal tunnel release surgery were effective for the treatment of carpal tunnel syndrome, but conventional surgery resulted in more postoperative complications.

Effect of Acupotomy Combined with Electroacupuncture Therapy on Finger Mobility and Pain Relief in Patients with Carpal Tunnel Syndrome

“…In terms of clinical effects, the treatment group after treatment had a remarkably higher cure rate than the control group ( P < 0.05), probably because acupotomy reduced the compression on median nerve in the carpal tunnel by cutting and loosening the transverse carpal ligament, addressing the cause of the disease at its source [ 21 ]. Some scholars believe that [ 22 , 23 ] the acupotomy treatment of CTS improves blood circulation, accelerates metabolism, and better repairs muscle ligament injury. Electroacupuncture promotes the repair of median nerve and the recovery of wrist function and can also dredge local meridian qi [ 24 ].…”

Mini-transverse incision using a novel bush-hook versus conventional open incision for treatment of carpal tunnel syndrome: a prospective study

“…There were multiple kinds of mini-incision approaches or novel instruments for CTR surgery [4,6,12,[14][15][16][17][18][19]. The assisted endoscopic technique was one among firstly used techniques, but was limited in wide use for high cost for purchase and maintenance, and the relatively higher rate of iatrogenic injury to vital structures [13].…”

Effectiveness and safety of surgical treatment of carpal tunnel syndrome via a mini-transverse incision and a bush hook versus a mid-palmar small longitudinal incision

“…Our minimal invasive technique using mini-bush hook can be an alternative to the endoscopic technique for CTR. As an early minimally invasive technique, endoscopic CTR has advantage in significantly reducing surgical site-related complications, but is limited to widespread use due to high cost of equipment and setup and need for a steep learning curve, increased risk of iatrogenic injury to nerve or blood vessel and occasionally the incomplete release [ 6 , 9 , 13 ]. In contrast, our minimally invasive technique is promising in widespread use for second- or primary-level medical institutions where endoscopic equipment was not affordable or not readily available, due to the very low cost, simple and easy operation to perform, hardly need of specific learning and more importantly the similar clinical results.…”

“…Numerous attempts for minimally invasive surgery have been introduced into practice for treatment of CTS, including endoscopic carpal tunnel release (ECTR) and various kinds of small incision surgery (mid- or root-palmar longitudinal incision, wrist palmar transverse incision) [ 6 , 8 ]. These methods each had their own advantages or disadvantages; however, no one method is absolutely superior to the other one [ 9 ]. Furthermore, most of them were small-sample pilot study, and the reported clinical results have hardly been validated.…”