Comparing open surgery with endoscopic releasing in the treatment of carpal tunnel syndrome

Abstract

Aim: The aim of this study is to retrospectively assess the complications and result of cases that underwent open surgery or endoscopic releasing for carpel tunnel syndrome. Method: A total of 50 cases of carpel tunnel syndrome, 30 of whom underwent endoscopic release using the biportal extrabursal technique described by Chow, and the other 20 that underwent open surgery were included in the study. Average age of the cases was 41 (24-62), 44 of them were females and 6 males. Results: Follow-up examinations of the patients at the first and third month after operation revealed no limitation of activity in 40 (80%) cases, minimal limitation in 4 (8%), moderate limitation in 5 (10%) and significant limitation in 1 (2%). Among the group that underwent endoscopic release, as a major complication, the median nerve was almost totally cut in a patient undergoing endoscopic release. During the same operation setting perifascicular neurorrhaphy was done. Fourth and fifth digital nerve lesions occurred in three cases. Among the group that underwent open surgery fourth and fifth digital nerve injury occurred in one case, and in another case severe inflammation requiring reoperation occurred. Conclusion: Before intervention, cases of carpal tunnel syndrome should be examined well as regards which technique to use. Experience of the surgeon with the technique to be used should also be taken into consideration. Endoscopic carpal tunnel releasing, though a relatively easier procedure, leads to neurovascular injuries more frequently than open surgery; thus open surgery appears to be safer.