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. 2025 Apr 23:21:511-522.
doi: 10.2147/TCRM.S514225. eCollection 2025.

Comparative Analysis of a New Device-Assisted Mini-Incision Versus Conventional Surgery for Carpal Tunnel Syndrome: A Retrospective Study of 109 Cases

Tianhao Guo  1 , Chenfei Li  1 , Dehu Tian  1 , Ruijiao Gao  2 , Kunlun Yu  1 , Naichao Sun  1 , Jing Yang  1 , Jiangbo Bai  1
Affiliations

Comparative Analysis of a New Device-Assisted Mini-Incision Versus Conventional Surgery for Carpal Tunnel Syndrome: A Retrospective Study of 109 Cases

Tianhao Guo et al. Ther Clin Risk Manag. .

Abstract

Study design: A retrospective cohort study.

Objective: This study aimed to compare the effectiveness and safety of the new device-assisted mini-incision approach for carpal tunnel release (CTR) with the conventional method.

Methods: A total of 109 patients diagnosed with primary carpal tunnel syndrome confirmed clinically were retrospectively included and divided into two groups based on the surgical approach: Group A (n=54) underwent surgery using a new device-assisted mini-incision, and Group B (n=55) received conventional surgery. Clinical outcomes, including pinch strength, grip strength, Visual Analog Scale (VAS) score, two-point discrimination (2-PD), Disabilities of the Arm, Shoulder, and Hand (DASH) score, and Boston Carpal Tunnel Questionnaire (BCTQ), were evaluated at 1, 3, and 6 months postoperatively. Additionally, operative time, incision length, wound pain, pillar pain, and the interval until return-to-work were compared between the two groups.

Results: At the 6-month follow-up, all patients in both groups had recovered. There were no significant differences between the two groups in postoperative pinch strength (P = 0.665), grip strength (P = 0.803), 2-point discrimination (2-PD) (P = 0.347), Visual Analogue Scale (VAS) score (P = 0.143), Disabilities of the Arm, Shoulder and Hand (DASH) score (P = 0.524), and Boston Carpal Tunnel Questionnaire (BCTQ) (SSS: P = 0.195; FSS: P = 0.103). Statistically significant differences were observed between the two groups in operation time (P < 0.001), incision length (P < 0.001), and return to work time (P < 0.001). Although at 6-month follow-up, there was no significant difference in the incidence of wound pain and pillar pain between the two groups. But the incidence of wound pain and pillar pain was lower in Group A (wound pain: 0%; pillar pain:0%) compared to Group B (wound pain: 5.5%; pillar pain:7.3%).

Conclusion: The device-assisted mini-incision technique provided comparable functional results to the conventional approach, with reduced complications and smaller incisions, supporting its use as a viable alternative in appropriate cases.

Keywords: carpal tunnel release; carpal tunnel syndrome; conventional approach; mini-incision approach.

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Conflict of interest statement

The authors report no competing interests in this work.

Figures

Figure 1
Figure 1
The new surgical device.(A) The push knife. (B) The dissection device. (C) The visualization device. (D and E) The metal guide.
Figure 2
Figure 2
Intraoperative pictures.(A) Before surgery. (B) Inserting the dissection device into the carpal tunnel. (C) Inserting the metal guide into the carpal tunnel. (D) Examination of carpal tunnel using the visualisation device. (E) Incision of the transverse carpal ligament guided by the visualisation device. (F) Re-examination of the carpal tunnel using the visualisation device (G) Stitch up the wound.
Figure 3
Figure 3
Intraoperative pictures taken with the visualization device. (A) Ensure no vital tissues between guide and transverse carpal ligament.(B) This image shows the transverse carpal ligament that has been cut. (C) The median nerve is completely released. (D) The tissues surrounding the median nerve are intact.
Figure 4
Figure 4
Incision and safe zone.
See this image and copyright information in PMC

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