Carpal tunnel syndrome is a common condition causing hand pain
and numbness. Endoscopic carpal tunnel release has been demonstrated
to reduce recovery time, although previous studies have raised concerns
about an increased rate of complications. The purpose of this prospective,
randomized study was to compare open carpal tunnel release with
single-portal endoscopic carpal tunnel release.
A prospective, randomized, multicenter center study was performed
on 192 hands in 147 patients. The open method was performed in ninety-five
hands in seventy-two patients, and the endoscopic method was performed
in ninety-seven hands in seventy-five patients. All of the patients
had clinical signs or symptoms and electrodiagnostic findings consistent
with carpal tunnel syndrome and had not responded to, or had refused,
nonoperative management. Follow-up evaluations with use of validated
outcome instruments and quantitative measurements of grip strength,
pinch strength, and hand dexterity were performed at two, four,
eight, twelve, twenty-six, and fifty-two weeks after the surgery.
Complications were identified. The cost of the procedures and the
time until return to work were recorded and compared between the
During the first three months after surgery, the patients treated
with the endoscopic method had better Carpal Tunnel Syndrome Symptom
Severity Scores, better Carpal Tunnel Syndrome Functional Status
Scores, and better subjective satisfaction scores. During the first
three months after surgery, they also had significantly (p < 0.05)
greater grip strength, pinch strength, and hand dexterity. The open
technique resulted in greater scar tenderness during the first three months
after surgery as well as a longer time until the patients could
return to work (median, thirty-eight days compared with eighteen
days after the endoscopic release). No technical problems with respect
to nerve, tendon, or artery injuries were noted in either group.
There was no significant difference in the rate of complications
or the cost of surgery between the two groups.
Good clinical outcomes and patient satisfaction are achieved more
quickly when the endoscopic method of carpal tunnel release is used.
Single-portal endoscopic surgery is a safe and effective method
of treating carpal tunnel syndrome.