Randomized Controlled Trial Comparing the Outcome of a Modified Mini-Incision Approach versus the Conventional Approach for Carpal Tunnel Release

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy that is best managed by surgical carpal tunnel release (CTR). CTR via the open approach remains the gold standard management of that condition. However, it has some complications like postoperative scar and pillar pain. Performing the procedure through mini-incision would be beneficial to decrease these complications. Objective: The purpose of this study was to compare the outcome of the modified mini-incision approach to the conventional one for carpal tunnel release. Patients and Methods: 68 patients were enrolled in our randomized prospective trial and were divided into two groups; Group A included patients who had the mini-incision approach, and Group B included patients who had the traditional approach. Results: The incision length was significantly shorter in Group A at the expense of operative time that was significantly prolonged in the same group. The time for wound healing and return to daily activities was significantly shorter in the same group. Both approaches led to a significant improvement in median nerve function manifested in the decline in latency period, increase in amplitude, and decrease in pain along the median nerve distribution. Nonetheless, the incidence of wound-related pain and pillar pain increased with the conventional approach. Conclusion: The mini-incision approach offers several advantages over the conventional approach. It is associated with less postoperative pain, fewer wound-related complications, faster recovery, and less incidence of recurrent symptoms. Nonetheless, the two approaches offer comparable effects on median nerve function.