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Endoscopic And Mini-Open Procedures Outshine Open Surgery For Carpal Tunnel Syndrome
A DGReview of :"Comparison of The Alternative Methods Used in The Surgical Treatment of Carpal Tunnel Syndrome"
Journal of Arthroplasty and Arthroscopic Surgery
06/10/2002
By David Loshak
Although open carpal tunnel release is the gold standard surgery for carpal tunnel syndrome, endoscopic and mini-open procedures produce better results.
Surgeons in Istanbul, Turkey, operated on 78 hands of 62 patients with idiopathic carpal tunnel syndrome. Most of these operations were open (n=51, 65 percent). A quarter were endoscopic (n=19 (24.4 percent) and a tenth were mini-open procedures (n=8, 10.3 percent).
Follow-up times were eight to 46 (mean 25) months. Patients were evaluated for resolution of the symptoms within three weeks of the operations and until they returned to normal daily activities.
In the early period after open surgery, 92 percent of the symptoms resolved, compared to 80 percent after endoscopic surgery and 89 percent after mini-open procedures.
Patient satisfaction was good in all groups. The return to daily activities took three weeks after open carpal tunnel release and two weeks after the other two procedures.
Except for scar tenderness in 10 percent of patients in the open group, there were no complications.
The recurrence rate in the open group was 2 percent. A high rate, 10 percent, in the endoscopic group, was attributed by the surgeons to their relative inexperience with this procedure. There was no recurrence after the mini-open procedure.
Patients returned to normal daily activates sooner after endoscopic and mini-open carpal tunnel release than after open surgery.
The morbidity rate after surgery in the open group was higher than in the other groups. The surgeons said they found none of the complications mentioned in the literature after endoscopic carpal tunnel release.
Journal of Arthroplasty and Arthroscopic Surgery 2002;13(1):5-9.
"Comparison of The Alternative Methods Used in The Surgical Treatment of Carpal Tunnel Syndrome"
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