Effectiveness of mini-transverse incision versus traditional reduced technique in the treatment of carpal tunnel syndrome. A prospective cohort study

Abstract

Background Carpal tunnel syndrome has attracted attention as an occupational disease due to the dramatic increase on its magnitude, and its prevalence in the general population, who's has been reported from a 0.6 to 3.4%. Currently, there are various techniques for its approach. However, there is great controversy when it comes to establishing which of the methods is the most beneficial. The objective of this study was to compare the efficacy of the mini-transverse incision against the traditional longitudinal technique in treatment of carpal tunnel syndrome. Materials and methods A series of cases is presented, prospectively included, of patients with a diagnosis of carpal tunnel syndrome, who are beneficiaries of a government hospital. We present a series of cases with a diagnosis of carpal tunnel syndrome, which were performed with two different techniques. Both techniques were evaluated by comparing the recovery and work reintegration times, as well as the decrease in pain and the absence of complications. Results A total of 8 patients operated with a minimal incision and 9 with a traditional reduced incision were studied. Significant differences were shown in the days taken to return to work, with a median of 17.5 (q25-q75 14–21) days for mini-transverse incision group and of 28 (q25-q75 21–28) days for the longitudinal traditional incision group ( p = 0.002). Likewise, differences were obtained in the visual analogue pain scale during the first week of evaluation 4 vs 7 ( p = 0.000), in contrast to complications where there were no differences at all. Conclusion The results obtained corroborate a greater efficacy of the mini-transverse incision technique, in reducing disability times. This favors the health institution to reduce the costs of rehabilitation and for the patient to have a prompt work reintegration. It is suggested to strengthen the scientific evidence that supports the use of this technique by exploring other areas such as functional status or long-term benefits.

A Clinical Outcome of Median Nerve Neurolysis For the Treatment of Carpal Tunnel Syndrome: Conventional S-Shaped Versus Transwrist Mini-Incision Techniques

“…Table [1] presented preoperative data including patient demographics. Patient's age ranged between 30 and 65 years.…”

“…It is due to median nerve compression during its passage through the inelastic, carpal tunnel. Thickening of the transverse carpal ligament due to daily repeated flexion and extension of the wrist, with resulting compression of the median nerve in the carpal tunnel is the pathogenic mechanism responsible for the development of CTS [1,2] . Other possible mechanisms include synovial hyperplasia, ganglion cysts or schwannoma, due to increased content in the carpal tunnel.…”

A Comparison of Mini Open Transverse Incision and Longitudinal Incision for the Release of Moderate and Severe Carpal Tunnel Syndrome

“…In this study, we aimed to investigate the clinical outcomes and patients’ satisfaction in patients who did open mini longitudinal incision versus transverse mini-invasive CTR. The major highlights of our studies are the large sample size (N = 480) in relation to other studies on the subject [ 9 - 11 ] and the fact that our study compares transverse mini-incision at the wrist crease to longitudinal mini-incision at the base of the palmar region while other studies compare transverse incision CTR to traditional open CTR [ 11 ]. Furthermore, our patients were followed and compared at regular intervals in time in the pre- and post-operative period and evaluated at each period in the post-operative period at one, three, and six months post operatively using a standardized scoring system for patients’ satisfaction and hand grip dynamometer to quantify the pre- and post-operative results in an objective and scientific manner while other studies on the subject did not apply the same systematic methodology [ 12 ].…”

Transverse mini-incision for carpal tunnel release

“…22 Several studies have investigated the clinical outcomes and efficacy of these two CTR techniques, but a consensus regarding the superior approach remains elusive. 12 While some studies report comparable outcomes between the two techniques in terms of symptom relief and functional improvement, 12,23,24 others suggest potential benefits of the transverse miniincision technique, including decreased scar tenderness and earlier return to daily activities. 23,24 However, variations in study designs, sample sizes, patient characteristics, and follow-up periods contribute to conflicting findings, emphasizing the need for a comprehensive investigation to draw definitive conclusions.…”

“…12 While some studies report comparable outcomes between the two techniques in terms of symptom relief and functional improvement, 12,23,24 others suggest potential benefits of the transverse miniincision technique, including decreased scar tenderness and earlier return to daily activities. 23,24 However, variations in study designs, sample sizes, patient characteristics, and follow-up periods contribute to conflicting findings, emphasizing the need for a comprehensive investigation to draw definitive conclusions. 25,26 Thus, the primary objective of this study was to compare the transverse mini-incision and traditional mini-palm incision techniques for CTR.…”