Comparison of morphologic consequences of open and endoscopic carpal tunnel release

Objectives: The objective of this study is to evaluate the carpal canal morphologic consequences following endoscopic carpal tunnel release compared with open approach. Methods: 48 Patients with CTS were enrolled in our prospective trial. Participants were classified in 2 groups: 24 patients underwent open surgery technique and 24 underwent endoscopic carpal tunnel decompression. Carpal canal shape and volume, configuration and position of contents, were analyzed by using imaging techniques. Results: Preoperative carpal canal volume in endoscopic patient group averaged 5.7 +/- 1.4 cc and 7.3 +/- 2.9 cc at 6 weeks postoperatively (28% +/- 7%, p = 0.018). In contrast preoperative carpal canal volume in open carpal tunnel release group averaged 4.9 +/- 1.1 cc (and increased to 6.2 +/- 1.7 cc at 6-week follow up investigation (36% +/- 5%, p = 0.002). Preoperative carpal arch width calculation in endoscopic carpal tunnel release group averaged 21.7 +/- 1.1 mm and 21.5 +/- 1.9 mm in open carpal tunnel release patients (p = 0.6575). Postoperative carpal arch width measurements in endoscopic carpal tunnel decompression group averaged 22.6 +/- 4.1 mm and 22.1 +/- 2.9 mm in open carpal tunnel release patient population at 6-week follow-up investigation (p = 0.628). Conclusion: Endoscopic approach causes an increment in carpal canal volume comparable to open technique and provides equivalent anatomic outcomes and will produce at least equivalent long-term clinical relief. (C) 2014 Elsevier B.V. All rights reserved.