[Surgical treatment of carpal tunnel syndrome: endoscopic or classical (open)? A prospective randomized trial]

Abstract

Objective: To compare the results of open with endoscopic release of the carpal tunnel in patients with the carpal tunnel syndrome.

Design: Randomised prospective study.

Setting: General hospital Zeeuws-Vlaanderen, Oostburg and Terneuzen, the Netherlands.

Method: 178 patients were randomised for open or endoscopic release. The symptom severity score and functional status score were completed before and three months after the procedure. One week after the operation the patients' postoperative pain was measured on a 10-point visual analogue scale. Differences were analysed using the Chi-square test or the t-test.

Results: Randomisation failed in two patients; 85 patients had an endoscopic release and 91 patients had an open release. The postoperative pain was significantly less in the endoscopic group. Improvement in symptom severity score and functional status score was the same in both groups. There was no difference in absence from work. Two local complications occurred in the endoscopically treated group. Of the patients 25% were not or only slightly satisfied with the results.

Conclusion: Endoscopic release of the carpal tunnel is as effective as the open release but it gives less postoperative pain. Because of the risk of complications and the additional costs, the endoscopic release is not the preferred method for treatment of the carpal tunnel syndrome, however.