Functional outcome following ‘mini open surgical release’ for Carpal Tunnel Syndrome

Abstract

Background: Carpal tunnel syndrome is the most common compression neuropathy in clinical practice. Various treatment modalities have been tried singly or in combination each with advantages and disadvantages. To avoid various complications and to make surgery easier, we attempted this simple and safe technique and evaluated it prospectively.

Subjects and Methods: This prospective study includes 180 patients (204 hands) with idiopathic carpal tunnel syndrome who presented to us between May 2008 and May 2012.

Inclusion Criteria: Diagnosed Cases undergoing Carpal Tunnel Release after failed conservative management, Age – 21 to 60 years, all cases who were confirmed by nerve conduction studies.
Exclusion Criteria: History of cervical, shoulder, elbow disorders, history of diagnosed neuromuscular skeletal disorders, post burn contracture, pregnancy, post trauma and Carpal tunnel syndrome due to systemic illness. About 1.5cm transverse skin incision was given. Transverse carpal ligament was released by protecting the nerve with the help of a modified insulin syringe. The pre & post-operative symptoms and functional status of hand are measured with visual analogue scale (VAS) for pain, Boston questionnaire for disability, grip strength and pinch strength. The follow up was measured until 12 months for all patients.
Results: The maximum symptomatic improvement (symptom severity scale ) was noted immediately within a day of surgery and maximum functional improvement (functional status scale , grip Strength and pinch strength)was noted between 10th post operative day to 3rd month.

None of the patient underwent second surgery for the same.
Conclusion: Transverse mini incision surgical release noted to be a simple, day care, economical, cosmetically well acceptable treatment option. Use of a syringe to protect the median nerve made the release easier and safer.