This article is more than 5 years old. Information may no longer be current.

Double small incisions technique results in good scar appearance for carpal tunnel release

Carpal tunnel release through double small incisions was minimally invasive with good nerve visualization that resulted in good appearance of scars compared with standard open release or endoscopic release procedures, according to study results published in Plastic and Reconstructive Surgery.

Researchers in China studied 207 patients with carpal tunnel syndrome, after excluding patients with mild symptoms or prior injuries to the extremity. Patients were randomly assigned to carpal tunnel release treatment using double small incisions (group A; n = 73; mean age, 46 years), standard incision (group B; n = 65; mean age, 45 years) or endoscopic release (group C; n = 69; mean age, 48 years).

Prior to surgery, the mean severity of symptoms and functional status, measured by Levine-Katz questionnaires, were 3.7 ± 0.58 and 3.2 ± 0.71 for group A; 3.8 ± 0.62 and 3.5 ± 0.64 for group B; and 3.7 ± 0.52 and 3.4 ± 0.56 for group C. Mean hospital costs were $1,817 ± $137 for group A, $1,765 ± $163 for group B and $2,266 ± $231 for group C.

Patient satisfaction was 95 ± 4.2 for Group A, 90 ± 5.8 for Group B and 93 ± 4.4 for group C, with significant differences in all comparisons.

The cohorts had no significant differences regarding symptom severity or function status (P > .05) and no significant differences with regard to age, gender, affected side or duration of symptoms (P > .05).

There were significant differences between groups A and B (P = .001) and B and C (P < .013) regarding scar appearances; however, the difference was not significant between cohorts A and C.

“Our study fund that carpal tunnel release through the double small incisions combined the advantages of the standard open carpal tunnel release and endoscopic carpal tunnel release,” the researchers wrote. “The advantages include a minimally invasive procedure, good visualization of the operating field, a less technically challenging procedure, a low wound complication rate and a good appearance.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.