Limited incision and traditional open carpal tunnel release

Abstract

Background: Carpal Tunnel Syndrome (CTS) is the most common compression neuropathy of the upper extremity. Even though traditional open release has been considered as standard approach for median nerve decompression, various other techniques are gaining popularity. The aim of this study was to compare the clinical and neurological outcomes between traditional open approach and limited incision approach. Methods: Twenty-eight patients with isolated CTS have included in this study of which four patients had bilateral CTS thus constituting 32 hands (19-right; 13-left). The patients were divided for treatment into two groups, Group A included 21 hands underwent limited incision release, and Group B included 11 hands released by traditional open incision. Patient's were evaluated preoperatively and in six weeks and six months postoperatively, namely, (a) clinical outcomes including Boston carpal tunnel questionnaire (BCTQ), postoperative scar tenderness, hypertrophic scar, pillar pain & quality of scar by Vancouver scar scale (VSS). (b) sensory testing using two-point discrimination (TPD) (c)motor testing using grip and pinch dynamometer, (d) neurological outcome measurement using nerve conduction study (NCS). Results: In each section of BCTQ outcomes, patients in group A showed significant improvement than in group B at both six weeks and six months follow up.