Mini-open carpal tunnel release: technique, feasibility and clinical outcome compared to the conventional procedure in a long-term follow-up

Abstract

We sought to evaluate the findings of our anatomically landmarks based mini-open procedure (MCTR) through a palmar approach and to compare its outcome and practicability to the conventional method (OCTR). The study consisted of 100 matched patients (n = 50 MCTR, n = 50 OCTR) with a minimum follow-up of three years. The outcome was characterized via the Disabilities of Arm, Shoulder and Hand Score (DASH), Symptom Severity Scale (SSS), Functional Status Scale (FSC), and Visual Analogue Scale (VAS). All adverse events were observed. An alpha of 0.05 and a confidence level of 95% were set for statistical analyses. Both techniques showed comparable functional results in a long-term period (mean follow-up MCTR: 60 months and OCTR: 54 months). MCTR versus OCTR at mean: DASH: 4.6/8.3 (p = 0.398), SSS: 1.3/1.2 (p = 0.534), FSC: 1.3/1.2 (p = 0.617), VAS: 0.4/0.7 (p = 0.246). The MCTR convinced through a lower rate of scar sensibility (MCTR: 0% vs. OCTR: 12%, 0/50 vs. 6/50; p = 0.007) and pillar pain, as well as a shortened recovery period and surgical time relative to the OCTR. Low complication rates were observed in both groups, no recurrences had to be documented. The MCTR procedure revealed a similar good clinical outcome as the conventional technique. MCTR is a minimally-invasive, reliable, fast and simple procedure with an obvious benefit regarding scar sensibility.