A Clinical Outcome of Median Nerve Neurolysis For the Treatment of Carpal Tunnel Syndrome: Conventional S-Shaped Versus Transwrist Mini-Incision Techniques

Abstract

Background: Carpal Tunnel Syndrome [CTS] is the commonest entrapment syndrome of peripheral nerves. Many surgical approaches are in use for median nerve release. However, there is no consensus on the optimal approach.The aim of the work: The current work aimed to evaluate the outcome of two surgical approaches: the open longitudinal mini-incision and conventional approach.Methods: This was a retrospective study compared conventional to mini-incision approach for CTS treatment. Ninety patients were included, 45 in each group. The collected data included general patient characteristics, median nerve conduction electrophysiological study, operative and postoperative data. The final assessment at the end of the third postoperative month.Results: Patient’s age ranged between 30 and 65 years, and females were predominant in both groups. there were no significant differences between conventional and mini-incision groups regarding patient characteristics, operable side, clinical signs, duration of symptoms, preoperative pain scores, functional scores and electrophysiological results. However, the operative time and incision length were significantly shorter among mini-incision than conventional group [19.02 ± 1.60 vs. 22.53 ± 3.62 minutes and 14.44 ± 2.34 vs. 33.49 ± 3.28 mm]. Patients experiencing surgical wound pain were significantly lower among mini-incision than conventional group [6.7% vs. 24.4%], and pain scores were significantly lower among patients in mini-incision group.Conclusion: The open mini-incision surgical approach for treatment of CTS is as effective as the conventional approach and it had advantages over it [mainly, shorter operative time and better aesthetic results].

Keywords

• surgical decompression
• carpal tunnel syndrome
• median nerve
• mini-incision
• pain