Abstract
Background
The present study aims to evaluate the patient-reported outcomes of endoscopic carpal
tunnel release (CTR) compared with open release in patients with electrodiagnostically
confirmed severe carpal tunnel syndrome (CTS).
Materials and Methods
Patients with severe CTS who underwent either open or endoscopic CTR between 2017
and 2021 were included in the study, with 38 patients in the open group and 35 in
the endoscopic group. Electronic medical records were reviewed for demographic and
clinical data, including preoperative Quick Disabilities of the Arm, Shoulder, and
Hand questionnaire (QuickDASH) scores. Patient outcomes, including postoperative QuickDASH
scores, were collected via telephonic survey.
Results
At the time of surgery, the median age of patients in the open group was 61 years
(interquartile range [IQR]: 54–69) and 66 years (55–76) in the endoscopic group. At
a mean of 5 years follow-up, complete resolution of symptoms was reported in 34 of
38 (89.5%) cases in the open group. In the endoscopic group, all 35 cases showed complete
resolution at a mean of 3 years follow-up. This difference was not statistically significant
(p = 0.116). Preoperative to postoperative QuickDASH scores improved by a median of
33.0 (IQR: 14.0–42.1) and 34.0 (25.0–54.3) points in the open and endoscopic groups,
respectively (p = 0.136). Minimal clinically important difference (MCID) on QuickDASH was achieved
in 68.4% of open releases and 85.6% of endoscopic releases (p = 0.101). There were no complications in either group, and patients reported high
satisfaction rates. After surgery, the length of time away from work was 9 (6–25)
days in the open group and 7 (2–23) days in the endoscopic group (p = 0.454).
Conclusion
The present study suggests that endoscopic and open CTR offer similar outcomes, supporting
both options as safe and effective treatment for severe CTS.
Keywords
carpal tunnel syndrome - endoscopic carpal tunnel release - open carpal tunnel release
- QuickDASH - severe
