Comparison of Conventional versus Mini-Incision Technique for Carpal Tunnel Release

Abstract: Background: Different surgical approaches are adopted for treating carpal tunnel syndrome (CTS) and these could be categorized as either endoscopic or non-endoscopic procedures. Data from Pakistan regarding these surgical techniques is very limited. Objective: To compare the transverse mini-incision (TMI) with the conventional incision technique for the treatment of CTS. Materials and Methods: This randomized controlled trial was carried out at the outpatient department of the Department of Orthopedics, Sahiwal Teaching Hospital, Sahiwal, Pakistan, from April 2022 to March 2023. A total of 46 patients were enrolled following the inclusion criteria of patients of both genders, aged between 18 and 70 years, presenting with symptoms of CTS for at least 3 months duration and having a visual analog scale (VAS) score of more than 4. Patients were randomly divided into conventional incision, and TMI group. Pre-procedure scores on the VAS, and the Functional Severity Scale (FSS) were noted to compare them postoperatively at the 2nd, 6th, and 12th weeks and at the 6- and 9-months follow-ups. Result: In a total of 46 patients, 28 (60.9%) were females. The mean age was 41.8±6.9 years. The mean VAS pain scores were significantly lower among patients of TMI group at 12-week (p=0.001), 6-month (p<0.001), and 9-month (p<0.001) for TMI group. Comparison of functional levels among both study groups showed that TMI group had significantly better scores at 3-month (p=0.023), 6-month (p<0.001), and 9-month (p<0.001) follow-up intervals. Conclusion: The TMI is better for relieving symptoms of CTS because its effects on pain and functional outcome are better than conventional incision. Keywords: Carpal tunnel syndrome, Conventional incision, Functional severity scale, Transverse mini incision, Visual analogue scale.