CARPAL TUNNEL SYNDROME: MINI-INCISION VERSUS ENDOSCOPIC TREATMENT

Abstract

Introduction and Objectives: Carpal tunnel syndrome (CTS) is the most frequent compressive neuropathy, it is seen in 1% of the general population. It mainly affects women between 40 and 60 years of age, and it is frequently bilateral. There are a variety of surgical techniques for its treatment, both open and endoscopic. The aim of this study is to compare the efficacy of the mini-incision and endoscopic techniques in the relief of symptoms and resumption of daily living activities; to assess risks and complications; and to determine the efficiency of each technique.

Materials and Methods: We compared 2 groups of 58 individuals, with idiopathic CTS, with a minimum 2 year follow-up The patients in group 1 were operated endoscopically, those in group 2 were operated using a minimally invasive technique; in both cases the median nerve was anesthetized. We described both surgical techniques. We applied a modified DASH test.

Results: There were no immediate or late complications or reoperations in any of the patients in either group. In group II 20% of the patients reported discomfort at the site of the scar on their first follow-up exam, this was not present 1 year after surgery. There was a slight subjective loss of force in 5% of the patients, with no differences between groups. The mean time of return to work was 21 days in both groups. All patients reported that they were satisfied with the results.

Discussion and Conclusions: Both techniques leave a minimal scar and have little morbidity. Endoscopic surgery requires a greater learning curve and has greater potential risks. The greater economic cost of this technique and the operating room time it requires lead us to prefer the use of the mini-incision technique for the treatment of TCS.