gms | German Medical Science

Objectives/Interrogation: Endoscopic carpal tunnel release (CTR) is an established and popular treatment for carpal tunnel syndrome (CTS), however there remains little patient reported experience comparing the post-operative outcome of the endoscopic approach with that of the open approach. Based on patient-reported data within 2 to 4 years post-CTR, this study investigated the hypothesis that endoscopic CTR would result in better functional outcome and patient-reported experience as compared to open CTR.

Methods: All patients fulfilling the following criteria at one urban hospital were included in the study: i) documented physician's diagnosis of CTS with NCS validation; ii) underwent unilateral CTR from the period of 2014 to 2016 with at least 2 years of post surgery review. Data collection was through review of medical records and telephone interview of patients: the patients' post-operative function was assessed using a validated questionnaire, which consisted of 28 questions pertaining to the following categories - demography, occupational history, subjective symptoms and patient satisfaction [1]. The QuickDASH tool was also used to evaluate the patient's physical function and symptoms of musculoskeletal disorders of the upper limb. Comparisons made between patients who underwent endoscopic and open surgery within the same year were analysed with chi square calculations to determine statistical significance.

Results and Conclusions: Two hundred and thirty-two patients were identified for data collection (79 males, 153 females), of which 51 (22.0%) underwent endoscopic CTR and 181 (78.0%) underwent open CTR. The proportion of patients opting for endoscopic CTR increased from 17.1% (2014) to 26.4% (2016), indicating an increasing preference for endoscopic CTR over open CTR. Right hand CTR was slightly more common than the left (92 versus 89 open cases and 43 versus 27 endoscopic cases respectively), and the average age of the patients was 57.8 (SD = 10.8). Details of the results and multi-variate analysis will be presented.

Endoscopic CTR has superior functional outcome from the patient's perspective as compared to open carpal tunnel release, using post-operative pain and rate of return to pre-morbid function as key indicators of recovery. Overall patient satisfaction and experience with CTR was good, and there was no significant superiority of the endoscopic approach over open surgery in terms of patient experience measures.