Modified mini-incision surgery for carpal tunnel syndrome: Technique and clinical outcome

Abstract

Carpal tunnel syndrome (CTS) is caused by the shortening of the median nerves in the wrist, resulting in hand pain and paralysis necessitating surgical operation for relief. Conventional open carpal tunnel release (CTR) procedures, involving long incisions, often lead to complications, delaying patients’ recovery for weeks or months. Therefore, mini-incision surgery has emerged as a preferred option, offering reduced pain, smaller wounds, and improved appearance. This study aimed to compare the outcomes of modified mini-incision surgery for CTS before and after the operation. It was a retrospective study involving 80 patients, with data collected from medical records pre- and post-operation, specifically at the 2^nd week, 3^rd month, 6^th month, 12^th month, and 24^th month intervals. Variables included operation time, incision length, pinch strength, gripping strength, two-point discrimination (2-PD), visual analogue scale (VAS), Levine score, quick disabilities of the arm, shoulder and hand (Quick-DASH), wound pain, and pillar pain. Data were analyzed using descriptive statistics and logistic regression, with a significant level of 0.05. The mean incision length was 11.54 mm. At the 2-week post-operative mark, the pinch strength was 5.43, gripping strength was 14.96, 2-PD was 5.84, the VAS score was 2.86, the Levine symptom was 3.84, and the DASH score was 69.43. There was a relationship (p-value<0.05) between preoperative and postoperative measures for pinch strength, gripping strength, 2-PD, and Levine symptom condition. The study on 80 patients who underwent modified mini-incision surgery for CTS at Naresuan University Hospital in Phitsanulok, Thailand, found that these parameters showed significant improvement postoperatively. Patients demonstrated good recovery and condition 2 weeks after the mini-incision surgery for CTS.