Clinical comparative study of open surgical treatments of carpal tunnel syndrome : mini open versus classical open incision

Abstract EN

Background : carpal tunnel syndrome is the commonest and the most important entrapment neuropathy that affects median nerve at wrist region more commonly in middle age females, resulting in certain sensory and / or motor dysfunction of median nerve.

Patients and methods : 40 patients with a carpal tunnel syndrome were individually randomized into the trial (mini-open incision CTR) (n = 20) and control group (classical technique CTR) (n = 20).

We followed up the patients of 2 groups for period of 6 months, observation has been done at third week, third month and 6month postoperatively, the patients were asked about symptomatic pain relief and functional status of the hand (including pinch and grip functional activities) and scored according to Boston Carpal Tunnel Questionnaire (BCTQ) score, and examined for palmar tenderness, esthetic outcome of scar and operation time were measure Results : 1- The mean symptom severity scores of BCTQ in both group decreased (improved) significantly within 3 weeks postoperatively.

2- The mean functional status scores of BCTQ is decrease earlier (in third month postoperatively) in the trial group where the difference is significant, whereas at sixth month the difference in mean of 2 group become not significant statistically.

3- The operation time is shorter in trial group.

4- The esthetic outcome and pillar tenderness is significantly better in trial group Conclusion.

1- mini-open technique is associated with significant minimal scar tenderness, esthetic outcome, and significant improvements in overall hand function and shorter in operation time than classical technique.

2- The symptoms (pain, numbness and parasthesia) in both mini-open technique and classical technique will relief early and significantly within 3weeks postoperatively.

3- The mini-open carpal tunnel release via a small palmar incision is a relatively simple and effective procedure.