Endoscopic versus open carpal tunnel release (Journal article)

Vasiliadis, H. S./ Xenakis, T. A./ Mitsionis, G./ Paschos, N./ Georgoulis, A.


PURPOSE: This study compared endoscopic carpal tunnel release with the conventional open technique with respect to short- and long-term improvements in functional and clinical outcomes. METHODS: We assessed 72 outpatients diagnosed with carpal tunnel syndrome. Of these patients, 37 underwent the endoscopic method according to Chow and 35 were assigned to the open method. Improvement in symptoms, severity, and functionality were evaluated at 2 days, 1 week, 2 weeks, and 1 year postoperatively. Changes in clinical outcomes were evaluated at 1 year postoperatively. Complications were also assessed. RESULTS: Both groups showed similar improvement in all but 1 outcome 1 year after the release; increase in grip strength was significantly higher in the endoscopic group. However, the endoscopic method showed a greater improvement in symptoms and functional status compared with the open method at 2 days, 1 week, and 2 weeks postoperatively. Separate analysis of the questions referring to pain showed that the delay in improvement in the open group was because of the persistence of pain for a longer period. Paresthesias and numbness decrease immediately after the operation with comparable rates for both groups. CONCLUSIONS: Endoscopic carpal tunnel release provides a faster recovery to operated patients for the first 2 weeks, with faster relief of pain and faster improvement in functional abilities. Paresthesia and numbness subside in an identical manner with the 2 techniques. At 1 year postoperatively, both open and endoscopic techniques seem to be equivalently efficient.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Keywords: Ambulatory Surgical Procedures/methods,Analgesics/therapeutic use,Anti-Inflammatory Agents/therapeutic use,Carpal Tunnel Syndrome/drug therapy/*surgery,Combined Modality Therapy,Decompression, Surgical/*methods,Discrimination (Psychology),Endoscopy/*methods,Female,Follow-Up Studies,Hand Strength,Humans,Male,Middle Aged,Neural Conduction,Pain, Postoperative/epidemiology/prevention & control,Reaction Time,Recovery of Function,Touch,Treatment Outcome
URI: http://olympias.lib.uoi.gr/jspui/handle/123456789/21973
ISSN: 1526-3231
Link: http://www.ncbi.nlm.nih.gov/pubmed/20117624
http://ac.els-cdn.com/S0749806309005738/1-s2.0-S0749806309005738-main.pdf?_tid=86bf8a9b6bd54651593558b1d7790619&acdnat=1333381784_cc8a50a09031da83dd86fd9f2b12f264
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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