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Published in: European Journal of Orthopaedic Surgery & Traumatology 8/2015

01-12-2015 | Original Article • WRIST - ARTHROSCOPY

Similar effectiveness of the open versus endoscopic technique for carpal tunnel syndrome: a prospective randomized trial

Authors: Seyit Ali Gümüştaş, Burcu Ekmekçi, Haci Bayram Tosun, Mehmet Müfit Orak, Halil İbrahim Bekler

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 8/2015

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Abstract

This prospective randomized study aims at evaluating the electrophysiological results of endoscopic and open carpal ligament release in patients with carpal tunnel syndrome. Included in the study were 41 patients diagnosed with carpal tunnel syndrome (21 hands in the endoscopic group and 20 hands in the open group). The Boston questionnaire was administered preoperatively and postoperatively to the patients, and their functional capacities and symptom severities were recorded. Physical examination was carried out preoperatively and in the postoperative sixth month. Demographic data and preoperative Boston symptomatic and functional scores were similar between both groups. A significant improvement was obtained in the Boston symptomatic and functional scores of both groups, but no significant difference was found between the groups in terms of improvement in the symptomatic and the functional scores. A significant shortening in median nerve motor distal latency and an increase in the velocity of sensory conductions were determined in both groups in the postoperative electromyography, but no difference was found between them in terms of improvement in the electromyography values. It was shown both clinically and electrophysiologically that endoscopic carpal tunnel surgery was as effective as open surgery as a treatment method for carpal tunnel syndrome.
Literature
1.
go back to reference Alfonso C, JannS Massa R, Torreggiani A (2010) Diagnosis, treatment and follow-up of the carpal tunnel syndrome: a review. Neurol Sci 31:243–252CrossRefPubMed Alfonso C, JannS Massa R, Torreggiani A (2010) Diagnosis, treatment and follow-up of the carpal tunnel syndrome: a review. Neurol Sci 31:243–252CrossRefPubMed
2.
go back to reference Werner RA, Andary M (2002) Carpal tunnel syndrome: pathophysiology and clinical neurophysiology. ClinNeuro physiol 113:1373–1381 Werner RA, Andary M (2002) Carpal tunnel syndrome: pathophysiology and clinical neurophysiology. ClinNeuro physiol 113:1373–1381
3.
go back to reference Stevens JC (1997) AAEM minimonograph #26: the electro diagnosis of carpal tunnel syndrome. American association of electro diagnostic medicine. Muscle Nerve 20:1477–1486CrossRefPubMed Stevens JC (1997) AAEM minimonograph #26: the electro diagnosis of carpal tunnel syndrome. American association of electro diagnostic medicine. Muscle Nerve 20:1477–1486CrossRefPubMed
4.
go back to reference Prime MS, Palmer J, Khan WS, Goddard NJ (2010) Is there light at the end of the tunnel? Controversies in the diagnosis and management of carpal tunnel syndrome. Hand 5:354–360PubMedCentralCrossRefPubMed Prime MS, Palmer J, Khan WS, Goddard NJ (2010) Is there light at the end of the tunnel? Controversies in the diagnosis and management of carpal tunnel syndrome. Hand 5:354–360PubMedCentralCrossRefPubMed
5.
go back to reference Duncan KH, Lewis RC Jr, Foreman KA, Nordyke MD (1987) Treatment of carpal tunnel syndrome by members of the American Society for Surgery of the Hand: results of a questionnaire. J Hand Surg Am 12:384–391CrossRefPubMed Duncan KH, Lewis RC Jr, Foreman KA, Nordyke MD (1987) Treatment of carpal tunnel syndrome by members of the American Society for Surgery of the Hand: results of a questionnaire. J Hand Surg Am 12:384–391CrossRefPubMed
6.
go back to reference Taleisnik J (1973) The palmar cutaneous branch of the median nerve and the approach to the carpal tunnel. An anatomical study. J Bone Joint Surg [Am] 55:1212–1217 Taleisnik J (1973) The palmar cutaneous branch of the median nerve and the approach to the carpal tunnel. An anatomical study. J Bone Joint Surg [Am] 55:1212–1217
7.
go back to reference Agee JM, McCarroll HR Jr, Tortosa RD, Berry DA, Szabo RM, Peimer CA (1992) Endoscopic release of the carpal tunnel: a randomized prospective multicenter study. J Hand Surg Am 17:987–995CrossRefPubMed Agee JM, McCarroll HR Jr, Tortosa RD, Berry DA, Szabo RM, Peimer CA (1992) Endoscopic release of the carpal tunnel: a randomized prospective multicenter study. J Hand Surg Am 17:987–995CrossRefPubMed
8.
go back to reference Palmer DH, Paulson JC, Lane-Larsen CL, Peulen VK, Olson JD (1993) Endoscopic carpal tunnel release: a comparison of two techniques with open release. Arthroscopy 9(5):498–508CrossRefPubMed Palmer DH, Paulson JC, Lane-Larsen CL, Peulen VK, Olson JD (1993) Endoscopic carpal tunnel release: a comparison of two techniques with open release. Arthroscopy 9(5):498–508CrossRefPubMed
9.
go back to reference Chow JC, Hantes ME (2002) Endoscopic carpal tunnel release: thirteen years’ experience with the Chow technique. J Hand Surg Am 27(6):1011–1018CrossRefPubMed Chow JC, Hantes ME (2002) Endoscopic carpal tunnel release: thirteen years’ experience with the Chow technique. J Hand Surg Am 27(6):1011–1018CrossRefPubMed
10.
go back to reference Malhotra R, Kiran EK, Dua A, Mallinath SG, Bhan S (2007) Endoscopic versus open carpal tunnel release: a short-term comparative study. Indian J Orthop 41:57–61PubMedCentralCrossRefPubMed Malhotra R, Kiran EK, Dua A, Mallinath SG, Bhan S (2007) Endoscopic versus open carpal tunnel release: a short-term comparative study. Indian J Orthop 41:57–61PubMedCentralCrossRefPubMed
11.
go back to reference Vasiliadis HS, Xenakis TA, Mitsionis G, Paschos N, Georgoulis A (2010) Endoscopic versus open carpal tunnel release. Arthroscopy 26(1):26–33CrossRefPubMed Vasiliadis HS, Xenakis TA, Mitsionis G, Paschos N, Georgoulis A (2010) Endoscopic versus open carpal tunnel release. Arthroscopy 26(1):26–33CrossRefPubMed
12.
go back to reference Jerosch-Herold C, Leite JC, Song F (2006) A systematic review of outcomes assessed in randomized controlled trials of surgical interventions for carpal tunnel syndrome using the International Classification of Functioning, Disability and Health (ICF) as a reference tool. BMC Musculoskelet Disord 5(7):96CrossRef Jerosch-Herold C, Leite JC, Song F (2006) A systematic review of outcomes assessed in randomized controlled trials of surgical interventions for carpal tunnel syndrome using the International Classification of Functioning, Disability and Health (ICF) as a reference tool. BMC Musculoskelet Disord 5(7):96CrossRef
13.
go back to reference Hasegawa K, Hashizume H, Senda M, Kawai A, Inoue H (1999) Evaluation of release surgery for idiopathic carpal tunnel syndrome: endoscopic versus open method. Acta Med Okayama 53(4):179–183PubMed Hasegawa K, Hashizume H, Senda M, Kawai A, Inoue H (1999) Evaluation of release surgery for idiopathic carpal tunnel syndrome: endoscopic versus open method. Acta Med Okayama 53(4):179–183PubMed
14.
go back to reference Faraj AA, Ahmed MH, Saeed OM (2012) A comparative study of the surgical management of carpal tunnel syndrome by mini-transverse wrist incisions versus traditional longitudinal technique. Eur J Orthop Surg Traumatol 22:221–225CrossRef Faraj AA, Ahmed MH, Saeed OM (2012) A comparative study of the surgical management of carpal tunnel syndrome by mini-transverse wrist incisions versus traditional longitudinal technique. Eur J Orthop Surg Traumatol 22:221–225CrossRef
15.
go back to reference Ferdinand RD, MacLean JG (2002) Endoscopic versus open carpal tunnel release in bilateral carpal tunnel syndrome. A prospective, randomised, blinded assessment. J Bone Joint Surg Br 84(3):375–379CrossRefPubMed Ferdinand RD, MacLean JG (2002) Endoscopic versus open carpal tunnel release in bilateral carpal tunnel syndrome. A prospective, randomised, blinded assessment. J Bone Joint Surg Br 84(3):375–379CrossRefPubMed
16.
go back to reference Saw NL, Jones S, Shepstone L, Meyer M, Chapman PG, Logan AM (2003) Early outcome and cost-effectiveness of endoscopic versus open carpal tunnel release: a randomized prospective trial. J Hand Surg Br 28(5):444–449CrossRefPubMed Saw NL, Jones S, Shepstone L, Meyer M, Chapman PG, Logan AM (2003) Early outcome and cost-effectiveness of endoscopic versus open carpal tunnel release: a randomized prospective trial. J Hand Surg Br 28(5):444–449CrossRefPubMed
17.
go back to reference Michelotti B, Romanowsky D, Hauck RM (2014) Prospective, randomized evaluation of endoscopic versus open carpal tunnel release in bilateral carpal tunnel syndrome: an interim analysis. Ann Plast Surg 73(2):157–160CrossRef Michelotti B, Romanowsky D, Hauck RM (2014) Prospective, randomized evaluation of endoscopic versus open carpal tunnel release in bilateral carpal tunnel syndrome: an interim analysis. Ann Plast Surg 73(2):157–160CrossRef
18.
go back to reference Heidarian A, Abbasi H, Hasanzadeh HM, Hajialibeyg A, Kalantar MSM, Seifirad S (2013) Comparison of knifelight surgery versus conventional open surgery in the treatment of carpal tunnel syndrome. Iran Red Crescent Med J 15(5):385–388PubMedCentralCrossRefPubMed Heidarian A, Abbasi H, Hasanzadeh HM, Hajialibeyg A, Kalantar MSM, Seifirad S (2013) Comparison of knifelight surgery versus conventional open surgery in the treatment of carpal tunnel syndrome. Iran Red Crescent Med J 15(5):385–388PubMedCentralCrossRefPubMed
19.
go back to reference Kang HJ, Koh IH, Lee TJ, Choi YR (2013) Endoscopic carpal tunnel release is preferred over mini-open despite similar outcome: a randomized trial. Clin Orthop Relat Res 471(5):1548–1554PubMedCentralCrossRefPubMed Kang HJ, Koh IH, Lee TJ, Choi YR (2013) Endoscopic carpal tunnel release is preferred over mini-open despite similar outcome: a randomized trial. Clin Orthop Relat Res 471(5):1548–1554PubMedCentralCrossRefPubMed
20.
go back to reference Chow JC (1993) The Chow technique of endoscopic release of the carpal ligament for carpal tunnel syndrome: four years of clinical results. Arthroscopy 9:301–314CrossRefPubMed Chow JC (1993) The Chow technique of endoscopic release of the carpal ligament for carpal tunnel syndrome: four years of clinical results. Arthroscopy 9:301–314CrossRefPubMed
21.
go back to reference Levine DW, Simmons BP, Koris MJ, Kawai A, Inoue H (1993) A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am 75(11):1585–1592PubMed Levine DW, Simmons BP, Koris MJ, Kawai A, Inoue H (1993) A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am 75(11):1585–1592PubMed
22.
go back to reference Katz JN, Punnett L, Simmons BP, Fossel AH, Mooney N, Keller RB (1996) Workers’ compensation recipients with carpal tunnel syndrome: the validity of self-reported health measures. Am J Public Health 86(1):52–56PubMedCentralCrossRefPubMed Katz JN, Punnett L, Simmons BP, Fossel AH, Mooney N, Keller RB (1996) Workers’ compensation recipients with carpal tunnel syndrome: the validity of self-reported health measures. Am J Public Health 86(1):52–56PubMedCentralCrossRefPubMed
23.
go back to reference Lewis C, Mauffrey C, Newman S, Lambert A, Hull P (2010) Current concepts in carpal tunnel syndrome: a review of the literature. Eur J Orthop Surg Traumatol 20:445–452CrossRef Lewis C, Mauffrey C, Newman S, Lambert A, Hull P (2010) Current concepts in carpal tunnel syndrome: a review of the literature. Eur J Orthop Surg Traumatol 20:445–452CrossRef
24.
25.
go back to reference Wong KC, Hung LK, Ho PC, Wong JM (2003) Carpal tunnel release. A prospective, randomised study of endoscopic versus limited-open methods. J Bone Joint Surg Br 85(6):863–868PubMed Wong KC, Hung LK, Ho PC, Wong JM (2003) Carpal tunnel release. A prospective, randomised study of endoscopic versus limited-open methods. J Bone Joint Surg Br 85(6):863–868PubMed
26.
go back to reference Ejiri S, Kikuchi S, Maruya M, Sekiguchi Y, Kawakami R, Konno S (2012) Short-term results of endoscopic (Okutsu method) versus palmar incision open carpal tunnel release: a prospective randomized controlled trial. Fukushima J Med Sci 58(1):49–59CrossRefPubMed Ejiri S, Kikuchi S, Maruya M, Sekiguchi Y, Kawakami R, Konno S (2012) Short-term results of endoscopic (Okutsu method) versus palmar incision open carpal tunnel release: a prospective randomized controlled trial. Fukushima J Med Sci 58(1):49–59CrossRefPubMed
27.
go back to reference Moharram AN, Kaptan WT, Hegazi MM, Kamal TT (2007) Carpal tunnel decompression: a randomised controlled trail of endoscopic versus open release. Pan Arab J Orth Trauma 11(1):96–101 Moharram AN, Kaptan WT, Hegazi MM, Kamal TT (2007) Carpal tunnel decompression: a randomised controlled trail of endoscopic versus open release. Pan Arab J Orth Trauma 11(1):96–101
28.
go back to reference Brown RA, Gelberman RH, Seiler JG et al (1993) Carpal tunnel release: a prospective randomized assessment of open and endoscopic methods. J Bone Joint Surg Am 75(9):1265–1275PubMed Brown RA, Gelberman RH, Seiler JG et al (1993) Carpal tunnel release: a prospective randomized assessment of open and endoscopic methods. J Bone Joint Surg Am 75(9):1265–1275PubMed
29.
go back to reference Murphy RX Jr, Jennings JF, Wukich DK (1994) Major neurovascular complications of endoscopic carpal tunnel release. J Hand Surg Am 19(1):114–118CrossRefPubMed Murphy RX Jr, Jennings JF, Wukich DK (1994) Major neurovascular complications of endoscopic carpal tunnel release. J Hand Surg Am 19(1):114–118CrossRefPubMed
30.
go back to reference Uchiyama S, Toriumi H, Nakagawa H, Kamimura M, Ishigaki N, Miyasaka T (2002) Postoperative nerve conduction changes after open and endoscopic carpal tunnel release. Clin Neurophysiol 113(1):64–70CrossRefPubMed Uchiyama S, Toriumi H, Nakagawa H, Kamimura M, Ishigaki N, Miyasaka T (2002) Postoperative nerve conduction changes after open and endoscopic carpal tunnel release. Clin Neurophysiol 113(1):64–70CrossRefPubMed
31.
go back to reference Sayegh ET, Strauch RJ (2015) Open versus endoscopic carpal tunnel release: a meta-analysis of randomized controlled trials. Clin Orthop Relat Res 473(3):1120–1132CrossRefPubMed Sayegh ET, Strauch RJ (2015) Open versus endoscopic carpal tunnel release: a meta-analysis of randomized controlled trials. Clin Orthop Relat Res 473(3):1120–1132CrossRefPubMed
32.
go back to reference Vasiliadis HS, Georgoulas P, Shrier I, Salanti G, Scholten RJ (2014) Endoscopic release for carpal tunnel syndrome. Cochrane Database Syst Rev 31;1: CD008265 Vasiliadis HS, Georgoulas P, Shrier I, Salanti G, Scholten RJ (2014) Endoscopic release for carpal tunnel syndrome. Cochrane Database Syst Rev 31;1: CD008265
33.
go back to reference Mavrogenis AF, Papagelopoulos PJ, Ignatiadis IA, Spyridonos SG, Efstathopoulos DG (2009) Complications of open carpal tunnel surgery: avoiding the pitfalls. Eur J Orthop Surg Traumatol 19(1):11–17CrossRef Mavrogenis AF, Papagelopoulos PJ, Ignatiadis IA, Spyridonos SG, Efstathopoulos DG (2009) Complications of open carpal tunnel surgery: avoiding the pitfalls. Eur J Orthop Surg Traumatol 19(1):11–17CrossRef
34.
go back to reference Senda M, Hashizume H, Terai Y, Inoue H, Nagashima H (1999) Electromyographic evaluation after endoscopic carpal tunnel release in idiopathic carpal tunnel syndrome. J Orthop Sci 4(3):187–190CrossRefPubMed Senda M, Hashizume H, Terai Y, Inoue H, Nagashima H (1999) Electromyographic evaluation after endoscopic carpal tunnel release in idiopathic carpal tunnel syndrome. J Orthop Sci 4(3):187–190CrossRefPubMed
35.
go back to reference Itsubo T, Uchiyama S, Momose T, Yasutomi T, Imaeda T, Kato H (2009) Electrophysiological responsiveness and quality of life (Quick DASH, CTSI) evaluation of surgically treated carpal tunnel syndrome. J Orthop Sci 14(1):17–23CrossRefPubMed Itsubo T, Uchiyama S, Momose T, Yasutomi T, Imaeda T, Kato H (2009) Electrophysiological responsiveness and quality of life (Quick DASH, CTSI) evaluation of surgically treated carpal tunnel syndrome. J Orthop Sci 14(1):17–23CrossRefPubMed
Metadata
Title
Similar effectiveness of the open versus endoscopic technique for carpal tunnel syndrome: a prospective randomized trial
Authors
Seyit Ali Gümüştaş
Burcu Ekmekçi
Haci Bayram Tosun
Mehmet Müfit Orak
Halil İbrahim Bekler
Publication date
01-12-2015
Publisher
Springer Paris
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue 8/2015
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-015-1696-0

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