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01.12.2015 | Review | Ausgabe 1/2015 Open Access

Journal of Orthopaedic Surgery and Research 1/2015

Endoscopic versus open carpal tunnel release for idiopathic carpal tunnel syndrome: a meta-analysis of randomized controlled trials

Zeitschrift:
Journal of Orthopaedic Surgery and Research > Ausgabe 1/2015
Autoren:
Dongqing Zuo, Zifei Zhou, Hongsheng Wang, Yuxin Liao, Longpo Zheng, Yingqi Hua, Zhengdong Cai
Wichtige Hinweise
Dongqing Zuo and Zifei Zhou contributed equally to this work.

Competing interests

All authors declare that they have no competing interests. All authors declare that they did not participate in any clinical trials included in the current study.

Authors’ contributions

The design of the study and preparation of the manuscript were done by ZD and WH. ZZ and LY assisted in the study processes, data collections, and preparations. ZL ,CZ and HY assisted in the manuscript preparation. All authors read and approved the final manuscript.

Authors’ information

ZD and ZZ are co-first authors.

Abstract

The objective of this study is to do a meta-analysis of the literature and compare the safety and efficacy of endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR) for idiopathic carpal tunnel syndrome (CTS). A comprehensive literature search of the electronic databases MEDLINE, EMBASE, Google Scholar, and the Cochrane Controlled Trial Register was undertaken for randomized studies reporting carpal tunnel syndrome treated with ECTR or OCTR. The quality of randomized trials was critically assessed. Pooled relative risk (RR) and 95% confidence intervals (CIs) for safety and efficacy outcome variables were calculated by fixed-effect or random-effect methods with RevMan v.5.1 provided by the Cochrane Collaboration. A total of 13 randomized trials were included by total retrieve and riddling. The results of our meta-analysis showed no significant difference in the overall complication rate (RR = 1.34, 95% CI [0.74, 2.43], P = 0.34), subjective satisfaction (RR = 1.0, 95% CI [0.93, 1.08], P = 0.92), time to return to work (mean difference = −3.52 [−8.15, 1.10], P = 0.14), hand grip and pinch strength, and the operative time (mean difference = −1.89, 95% CI [−5.84, 2.06]) between patients in the ECTR and OCTR groups (P = 0.16, 0.70, and 0.35, respectively). The rate of hand pain (RR = 0.73, 95% CI [0.53, 0.93], P = 0.02) in the ECTR group was significantly lower than that in the OCTR group. ECTR treatment seemed to cause more reversible postoperative nerve injuries as compared with OCTR (RR = 2.38, 95% CI [0.98, 5.77], P = 0.05). Although ECTR significantly reduced postoperative hand pain, it increased the possibility of reversible postoperative nerve injury in patients with idiopathic CTS. No statistical difference in the overall complication rate, subjective satisfaction, the time to return to work, postoperative grip and pinch strength, and operative time was observed between the two groups of patients.
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