Prospective comparison of endoscopic and open surgical methods for carpal tunnel syndrome.

Ye Tian, Hong Zhao, Ting Wang
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Abstract

Objective: To compare outcomes of patients undergoing either open or endoscopic carpal tunnel release for the treatment of idiopathic carpal tunnel syndrome.

Methods: A prospective, randomized study was performed on 70 hands in 62 patients with idiopathic carpal tunnel syndrome from April 2000 to April 2004. Either open (36 hands in 30 patients) or endoscopic (34 hands in 32 patients) carpal tunnel release was performed randomly. Symptom improvement, complications, and the time of operation, in-hospital stay, and return to work between the two groups were assessed with average 2 years of follow-up. The electromyography was tested pre- and 3 months post-operation.

Results: There were no significant differences between the two surgical groups with regard to postoperative improvements of symptom, electromyography tests, and the incidence of complications. But it was statistically less in the rate of scar tenderness, the time of operation, in-hospital stay, and return to work in the endoscopic group compared with the open group (P < 0.05).

Conclusions: The endoscopic carpal tunnel release is a reliable method in the treatment of idiopathic carpal tunnel syndrome. And it has the advantages of slight scar tenderness, less operation time, less in-hospital stay, early functional recovery, safety, and high- satisfaction rate compared with open methods.

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内窥镜与开放手术治疗腕管综合征的前瞻性比较。
目的:比较切开或内窥镜下腕管松解术治疗特发性腕管综合征的疗效。方法:对2000年4月至2004年4月62例特发性腕管综合征患者70只手进行前瞻性随机研究。随机进行切开(30例36手)或内窥镜(32例34手)腕管松解。平均随访2年,评估两组患者的症状改善、并发症、手术时间、住院时间和重返工作岗位情况。分别于术前和术后3个月进行肌电图测定。结果:两组患者在术后症状改善、肌电图检查及并发症发生率方面均无显著差异。但内镜组瘢痕压痛率、手术时间、住院时间、复工率均低于开放组,差异有统计学意义(P < 0.05)。结论:内镜下腕管松解术是治疗特发性腕管综合征的可靠方法。与开放式手术相比,具有瘢痕压痛轻、手术时间短、住院时间短、功能恢复早、安全性高、满意率高等优点。
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