Proximal carpal crease incision for carpal tunnel release: a pilot study

Abstract

Introduction and aims . Palmar Incision for Carpal Tunnel Release (PITR) is the standard approach for treatment of carpal tunnel syndrome. Proximal Carpal Crease Incision (PCCI) is an investigated alternative. Aim - To evaluate and compare safety and results of PITR and PCCI approaches. Material and methods . A prospective pilot study was carried out in the period of November 2011- November 2013. Patients were randomized into 2 groups according to the incision. Measured characteristics: safety, severity of pain, DASH test, hand grip and pinch strength. Data were collected before surgery, in the early (2-3 weeks after operation) and late (3-4 months after operation) post-operative periods. Significance level of 0,05 was considered for testing statistical hypotheses. Results . 45 patients (♀ 78,8% (35), ♂ 22,2% (10), mean age 55,14±14,33 were recruited for the study. Group 1 (PITR) - 31 patients, group 2 (PCCI) - 14 patients. Early and late post-operative results were evaluated 20,96±7,46 and 110,33±37,73 days after the operation. Results in early and late post-operative periods, respectively: pain score - PITR 2,36 ± 2,80, PCCI 1,64±2,37; PITR 1,45±2,54, PCCI 0,43±1,60 ( p>0,05); DASH score - PITR 36,8±21,14, PCCI 28,14±18,65; PITR 13,07±16,98, PCCI 10,13±16,66 ( p>0,05); hand grip strength - PITR 16,65±11,38, PCCI 21,79±12,66; PITR 26,85±11,12, PCCI 29,61±14,54 ( p>0,05); pinch strength - PITR 4,35±2,38, PCCI 5,67±2,50; PITR 5,90±2,07, PCCI 7,21±2,81 ( p>0,05). No complications appeared in both groups. Conclusion. Pilot study suggests that Proximal Carpal Crease Incision is a safe alternative with a tendency for better recovery after PCCI carpal tunnel release.