Open versus endoscopic release of carpal tunnel syndrome: A non-concurrent cohort study.

A non-concurrent cohort study was conducted at St. Luke's Medical Center (SLMC) on Filipino patients diagnosed with primary idiopathic carpal tunnel syndrome (CTS), aged 30-65years old, and underwent carpal tunnel release (CTR) between November 2004 to July 2006. Diagnosis was based on a characteristic history and a nerve conduction test showing median neuropathy at the wrist. Primary outcome measure was functional outcome using the DASH questionnaire and length of return to activities of daily living. Secondary outcomes were adverse effects and post operative complication after surgery. The cost of the procedures were also recorded and compared between the groups.

There was a significant difference in the mean DASH score between the two groups (P=0.0015) and in the mean length of days to return to normal activities of daily living (P=0.0002). The overall complication rate was higher in the open group (45 percent) compared to (18 percent) in the endoscopic group, although the difference was not statistically significant at (P=0.05). The mean cost of endoscopic carpal tunnel surgery was more expensive than open carpal tunnel release.

The two groups were similar in terms of adverse events. Endoscopic release of carpal tunnel had better functional outcome in terms of DASH functional score and had faster return to activities of daily living. However, endoscopic carpal tunnel equated with higher operative cost which will limit its use to the general population afflicted with this common condition.