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BMC Musculoskeletal Disorders

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Open Access 01-12-2020 | Nerve Injury | Research article

Open versus endoscopic carpal tunnel release: a systematic review and meta-analysis of randomized controlled trials

Authors: Yueying Li, Wenqi Luo, Guangzhi Wu, Shusen Cui, Zhan Zhang, Xiaosong Gu

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

Abstract

Background

Endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR) both have advantages and disadvantages for the treatment of carpal tunnel syndrome (CTS). We compared the effectiveness and safety of ECTR and OCTR based on evidence from a high-level randomized controlled trial.

Methods

We comprehensively searched PubMed, EMBASE, Cochrane Library, Web of Science, and Medline to identify relevant articles published until August 2019. Data regarding operative time, grip strength, Boston Carpal Tunnel Questionnaire scores, digital sensation, patient satisfaction, key pinch strength, return to work time, and complications were extracted and compared. All mean differences (MD) and odds ratios (OR) were expressed as ECTR relative to OCTR.

Results

Our meta-analysis contained twenty-eight studies. ECTR was associated with significantly higher satisfaction rates (MD, 3.13; 95% confidence interval [CI], 1.43 to 4.82; P = 0.0003), greater key pinch strengths (MD, 0.79 kg; 95% CI, 0.27 to 1.32; P = 0.003), earlier return to work times (MD, − 7.25 days; 95% CI, − 14.31 to − 0.19; P = 0.04), higher transient nerve injury rates (OR, 4.87; 95% CI, 1.37 to 17.25; P = 0.01), and a lower incidence of scar-related complications (OR, 0.20; 95% CI, 0.07 to 0.59; P = 0.004). The permanent nerve injury showed no significant differences between the two methods (OR, 1.93; 95% CI, 0.58 to 6.40; P = 0.28).

Conclusions

Overall, evidence from randomized controlled trials indicates that ECTR results in better recovery of daily life functions compared to OCTR, as revealed by higher satisfaction rates, greater key pinch strengths, earlier return to work times, and fewer scar-related complications. Our findings suggest that patients with CTS can be effectively managed with ECTR.

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Title: Open versus endoscopic carpal tunnel release: a systematic review and meta-analysis of randomized controlled trials
Authors: Yueying Li
Wenqi Luo
Guangzhi Wu
Shusen Cui
Zhan Zhang
Xiaosong Gu
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Nerve Injury
Carpal Tunnel Syndrome
Incision
Carpal Tunnel Syndrome
Published in: BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-020-03306-1

At a glance: The STEP trials

Springer Medicine

Open versus endoscopic carpal tunnel release: a systematic review and meta-analysis of randomized controlled trials

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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