Abstract
A randomised controlled trial involving 24 patients ( 32 wrists ), 18 wrists being allocated to the single incision group ( S ) and 14 to the double incision group ( D ), was carried out between 1996 and 1999, after clinical evaluation and complimentary EMG studies. Randomisation was performed by one of the orthopaedic secretaries using an envelope technique on the morning of admission. Mean ages were 49.6 ( 32 to 69 ) and 45.8 ( 30 to 54 ) in the S and D groups respectively. The male to female ratios were 2/12 and 5/7 respectively. The pre- and post-operative mass grip strength was measured by a Jamar dynanometer and assessment of post-operative parameters included pillar pain, scar sensitivity, nerve compression symptoms and return to work.
Pillar pain was significantly less in Group D ( Chi-squared = 8.22; P = 0.004 ).
Return to work was less in Group D ( average = 2.6 weeks ( 1 to 12 weeks )) cf. to Group S ( average = 5.6 weeks ( 2 to 16 weeks ) ). ( Wilcoxon Rank Sum Test P = 0.0004 ). No differences occurred in post-operative clinical symptoms ( P > 0.05 ), scar sensitivity ( Chi-squared = 1.025 ; P = 0.506 ) or mass grip strength ( P= 0.506 ).
The tourniquet time was longer for the double incision technique ( average = 15.3 minutes ( 12 to 18 minutes )) cf. to the single incision technique ( average = 12.2 minutes ( average = 10 to 18 minutes )).
The double incision technique is a safe and easy technique for uncomplicated carpal tunnel syndrome resulting in a significant reduction in pillar pain and a more rapid return to work.
The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom.
