Endoscopic versus open carpal tunnel release for idiopathic carpal tunnel syndrome: a meta-analysis of randomized contro
- PDF / 1,984,087 Bytes
- 13 Pages / 595.276 x 793.701 pts Page_size
- 70 Downloads / 201 Views
REVIEW
Open Access
Endoscopic versus open carpal tunnel release for idiopathic carpal tunnel syndrome: a meta-analysis of randomized controlled trials Dongqing Zuo1†, Zifei Zhou1†, Hongsheng Wang1, Yuxin Liao1, Longpo Zheng1*, Yingqi Hua2 and Zhengdong Cai2
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.
Introduction Carpal tunnel syndrome (CTS) is one of the most common causes of neuropathy in the upper extremities. It occurs most often in patients aged 30 to 60 years and is two- to threefold more common in women than in men [1]. In many cases, no underlying condition can be diagnosed, rendering it idiopathic, although CTS is associated with rheumatoid arthritis (RA) and other inflammatory arthropathies, trauma, diabetes, acromegaly, hypothyroidism, and pregnancy [2]. The diagnosis mainly depends on clinical symptoms and electrodiagnostic tests. When nonsurgical treatments including local steroid injections, * Correspondence: [email protected] † Equal contributors 1 Department of Orthopaedics, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, 200072 Shanghai, China Full list of author information is availa
Data Loading...
