Comparative results of standard open and mini open, KnifeLight instrument-assisted carpal tunnel release

Abstract

Purpose: The purpose of our study was to compare the results of standard open and mini open (approximately 1.5-cm incision), KnifeLight instrument (Stryker Instruments, Kalamazoo, Michigan, USA) assisted carpal tunnel release (CTR) concerning symptomatic, functional, and electrophysiological aspects, as well as complications during early and late postoperative follow-up.

Patients and method: Seventy-five patients who did not improve with nonsurgical methods and were planned to undergo surgery were separated into two groups. Patients in the first group (n = 37) underwent surgery with standard open CTR (Group A); patients in the second group (n = 38) underwent surgery with mini open KnifeLight instrument assisted CTR (Group B). Preoperative and 6-month postoperative electrophysiological values and functional utilization of the operated hand of both groups were compared. Nerve conduction studies were used for electrophysiological evaluation, visual analog scale (VAS) was used for pain evaluation, symptom severity scale (SSS) was used for symptomatic evaluation, and functional status scale (FSS) was used to evaluate hand functions that are the part of the Boston Carpal Tunnel Questionnaire. All evaluations were done preoperatively and repeated at postoperative month 6. Also, to determine early effects of surgical procedures, SSS and FSS scales were repeated at postoperative week 2 and month 3. Groups were also compared for complications and need for reoperation.

Results: No significant difference was detected between the two groups at postoperative month 6 on VAS and electrophysiological values. Postoperative week 2 FSS and SSS scores of Group B were significantly lower than Group A. Although scores were lower in Group B at month 3, there was no statistically significant difference. Six months after surgery, no significant difference was detected between the two groups in mean SSS and FSS scores. Postoperative complications and reoperation rates were lower in Group B but the difference was not statistically significant.

Conclusion: After 6 months the results of both techniques for CTR are comparable. Mini open KnifeLight instrument assisted CTR is easy to perform and is superior to standard open CTR in the early post-operative period.