Outcome Assessment of Carpal Tunnel Release via Mini-Open Wrist Crease Incision versus Standard Open Incision in Suez Canal University Hospitals

Abstract

Background Data: Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment syndrome, with a prevalence rate of 8%. The most common technique for release is the standard open incision (SOI); however, new techniques, including mini-open wrist crease incision (MOWCI), are reported with more rapid return of hand function, less scar, and less tenderness postoperatively. Study Design: This is a prospective randomized controlled trial. Purpose: This study aims to compare the outcomes of MOWCI with SOI for managing CTS. Patients and methods: Prospective data were gathered from patients who underwent surgery for carpal tunnel syndrome (CTS) from September 2021 to December 2022. Patients’ allocation for either MOWCI or SOI was at random. Patients were submitted for wrist ultrasound and nerve conduction studies (NCS) of the median nerve preoperatively. VAS score and Boston questionnaire were used to compare the preoperative and postoperative status of the patients. Results: Twenty-four hands were allocated for each study group. The mean operative time was significantly shorter in the MOWCI group. Both groups showed significant improvement in VAS, SSS, and FSS of the Boston questionnaire at six months postoperatively. The return of hand function was significant in the MOWCI group, especially at two weeks. Both groups showed substantial improvement in NCS and ultrasound parameters of the median nerve three months postoperatively p value <0.001*. Conclusion: The outcome was not significantly different between both techniques over the study period and the MOWCI technique can be considered a safe alternative technique for the SOI technique.