Median nerve release is one of the most common procedures performed in hand surgery (classical incision or endoscopic methods), with a low complication rate, but not free of morbidity conditioning work reincorporation.

We present a comparative study between the classical technique and double-incision approach of median nerve preserving the intereminencial space.

Material and methods. A review of 155 hands in 133 patients (all operated by the same surgeon), divided in two separate groups:

– 72 hands (61 patients) operated by classical technique.

– 83 hands (72 patients) operated by double-incision approach.

Excluding criteria: patients under 30 years-old, antecedents or symptoms of associated local pathology, trophic troubles of thenar or hypothenar eminences and recurrent carpal tunnel syndrome.

We reviewed: per-operatory neurovascular complications, difficulties in hand activity related to pillar pain at 10 and 21 days and 3 and 12 months after surgery, discomfort in the thenar-hypothenar areas (intereminencial pruritus), remaining discomfort in the area of the surgical scar at 3 and 12 months after surgery, and recurrences at 24 months.

Results: Nerve compression symptoms disappeared in all 155 hands and neither complications nor recurrences were observed at 24 months.

Pillar pain conditioning hand activity:

21 days: A-group 32 cases (44 %) %, B-group 0%

3 months: A-group 18 cases (25 %), B-group 0%

12 months: A-group 5 cases (7 %), B-group 0%

Discomfort in the thenar-hypothenar areas (inter-eminencial pruritus):

21 days: A-group 0%, B-group 15 cases (18 %)

3 months: A-group 0%, B-group 6 cases (7 %) Remaining discomfort in surgical scars areas:

3 months: A-group 18 cases (25%) palm area, B-group 4 cases (5 %) wrist area.

12 months: A-group 5 cases (7 %) palm area, B-group 0%

Conclusion: Absence of pillar pain in double-incision approach and free hand activity 3-4 weeks post-operatively were obtained, only a discrete intereminencial pruritus was observed (unusual at 3 months).

We therefore consider this technique as a first choice in suitable patients as it avoids discomfort or disability. Furthermore this technique is of low risk and low cost.