Endoscopic Versus Open Carpal Tunnel Release: Setup of a Prospective Randomised Study
When Chow and Okutsu in 1989 introduced the endoscopic technique for carpal tunnel release an overall interest in this new technique led to proliferation of numerous methods of endoscopic releasing with claims of enhanced results while sustaining the efficacy of traditional “open” techniques (Chow 1989, Okutsu et al. 1989, Brown et al. 1993, Feinstein 1993, Resnik et al. 1991, Skoff et al. 1993). In these series the method turned out to be reliable, producing reasonable results with low comphcation rates. Nevertheless, a distinct clinical advantage of the endoscopic method compared with the open technique could not be presented until now. A clinical advantage from the endoscopic technique is mandatory, simply to justify the higher costs for this kind of surgery. The small number of prospective comparisons published in the literature (Agee et al. 1992, Brown et al. 1993, Hallock et al. 1994, Worseg et al. 1996) concluded that both methods produce similar results. In these studies the diagnosis was usually defined as idiopathic carpal tunnel syndrome without respect to the duration of the patient’s history and the severity of the nerve compression syndrome. The question remains open whether a distinct subgroup of patients may profit to a greater extent from the endoscopic procedure than other subgroups. A clinical study was designed in order either to establish subgroups of patients suffering from carpal tunnel syndrome and to compare endoscopic with “open” carpal tunnel release in a prospective randomised study applied to the defined subgroups of patients suffering from carpal tunnel syndrome.
KeywordsGrip Strength Median Nerve Carpal Tunnel Syndrome Carpal Tunnel Endoscopic Technique
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