Background
There is no universal agreement on the effectiveness and safety of various methods for carpal tunnel release, and their numerous modifications. Multiple minimally invasive techniques have been proposed to decrease postoperative morbidity. However, there are concerns regarding the risk for neurovascular injury and incomplete decompression.
Patients and methods
To evaluate the safety and efficacy of carpal tunnel release using a mini-open, blind, double-incision technique (group I) versus the limited-open technique (group II), a prospective double-cohort study on a total of 90 consecutive patients presenting with idiopathic carpal tunnel syndrome resistant to conservative treatment was conducted. Safety was measured by the prevalence of complications and revision surgery, whereas efficacy was measured by the Boston Carpal Tunnel Syndrome Questionnaire, pinch grip strength, the static 2-point discrimination test, and patient satisfaction with the cosmetic result of the procedure.
Results
All parameters (except the median pinch strength at 1 month) showed progressive postoperative improvement, with no significance difference between the two groups. The mini-open, blind, double-incision technique resulted in a higher degree of postoperative patient satisfaction with the cosmetic result, fewer surgical site complications and less painful scar, shorter operative time, and earlier restoration of pinch grip strength. This, however, did not translate directly into Levine functional and symptom scores that differed significantly between the two groups.
Conclusion
Both techniques described in the study led to good, comparable clinical results. However, experience with the mini-open double-incision technique is encouraging as it represents a safe and effective line of management for idiopathic carpal tunnel syndrome.