Original Communications: NerveEndoscopic versus open carpal tunnel release: A randomized trial☆,☆☆,*,**,♢
Section snippets
Study design
A randomized clinical trial comparing open and endoscopic procedures was conducted. Sample size calculations were performed to ensure 80% power to detect differences in the primary outcome measure, the Symptom Severity Scale.9 Patients were randomized in an unbalanced design with a 3:1 probability of receiving an endoscopic procedure. This design was chosen because of the controversy over complication rates for ECTR as compared with relatively stable and long-standing estimates for OCTR. Three
Results
No difference between the groups was observed in either of the primary outcomes at any of the observation points. No vascular or nerve complications occurred and Symptom Severity Scores improved equally well over time (Fig. 1).A slight increase in symptoms was noted the first week after surgery that was attributed to postoperative pain and swelling but symptoms improved dramatically in both
Discussion
This study found that patients having ECTR had a transient benefit in grip and pain compared with patients who had a traditional open release but there were no differences evident by 3 months after surgery. Unlike some trials these short-term benefits did not translate into earlier return to work. Furthermore the 2 primary outcomes, carpal tunnel symptoms and complications, showed no differences between the groups at any point in time. In the absence of specific data to define the clinically
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Cited by (0)
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No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
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Supported by the physicians of Ontario through the Physicians Services Incorporated Foundation.
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This article won the prize for best scientific paper at the 2001 Annual Meeting of the American Society for Hand Therapists.
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Reprint requests: Joy C. MacDermid, PhD, Co-director, HULC Clinical Research Laboratory, Monsignor Roney Ambulant Care Centre, 930 Richmond St, London, Ontario, Canada N6A 3J4.
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0363-5023/03/28A03-0019$30.00/0