Early Versus Delayed Endoscopic Surgery for Carpal Tunnel Syndrome: A Prospective Study

Pankaj Kumar Singh, MD1, P S Chandra1

1New Delhi, India

Keywords: carpal tunnel syndrome, technique, nerve, endoscopic surgery, outcome

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Abstract

     
     The present study is aimed to evaluate the effects of early verses delayed endoscopic surgery in the patients of Carpal tunnel syndrome (CTS).
     The study included 104 patients of CTS.
     Pre surgical investigations were done. The Jeremy DP bland neurophysiological grading scale for CTS was used for assessment. The patient underwent endoscopic surgical procedure using indigenously designed instrument.
     Moderately severe CTS (score 3 or 4) were randomized for the study. Treatment was offered in two groups viz. early (< 1 week), (n=54) and delayed surgery as per the usual waiting list (6 months) and hence acted as the delayed surgical arm after a course of conservative treatment (n=50). The improvement in both the groups was significant (P<0.001). When both the groups were compared improvement was better for early surgery (P<0.001, CI-6.22 to 8.57).
     This is a prospective non-randomized study.
     On the basis of this study we propose an early surgery in patients moderately severe CTS.
     Additionally endoscopic approach has provided the advantages of reducing the surgery duration, cosmetic appeal, patient compliance and early return to activities with less post operative discomfort


Acknowledgements

Project Roles:

P. Singh (), P. Chandra ()