Ultrasound-guided minimally invasive thread release of carpal tunnel: a cadaveric study

Ultrasound-Guided Percutaneous Release and Mini-Open Surgery in Carpal Tunnel Syndrome: A Comparison of Short- and Long-Term Outcomes

Background and Objectives: The aim of this study was to compare the short- and long-term effectiveness of ultrasound-guided percutaneous release (CTR-US) and mini-open surgery in the treatment of carpal tunnel syndrome (CTS). Materials and Methods: A retrospective analysis was conducted on 172 patients who underwent surgical treatment for CTS between 2015 and 2020. The patients were divided into two groups: those who underwent CTR-US (Group A, n = 66) and those treated with mini-open surgery (Group B, n = 106). All patients were evaluated using the Boston Carpal Tunnel Questionnaire (BCTQ) and the Quick Disabilities of the Arm, Shoulder, and Hand (QDASH) scores before surgery and at 3 months, 6 months, 1 year, 2 years, and 5 years postoperatively. Electrophysiological and ultrasound findings were also compared. Statistical analyses were performed using t-tests, Mann-Whitney U tests, and Chi-square tests, with significance set at p < 0.05. Results: A total of 172 patients who met the study criteria were included. Among the participants, 112 were women and 60 were men. The mean age was calculated as 61 years for female patients and 54 years for male patients. No significant differences were found between the groups in terms of age, gender, laterality, and disease duration. Both groups demonstrated significant improvements in BCTQ and QDASH scores at all postoperative time points compared to preoperative scores (p < 0.001). The CTR-US group showed advantages in shorter treatment duration (p < 0.001), lower cost (p < 0.05), and faster recovery time. Electrophysiological evaluations revealed faster improvements in distal motor latency (DML) and sensory conduction velocity (SCV) in the CTR-US group (p < 0.05). Ultrasound assessments indicated that both methods achieved effective release of the transverse carpal ligament. No significant differences were observed between the groups in long-term questionnaire scores. Conclusion: CTR-US offers advantages such as shorter treatment duration, lower cost, and faster recovery due to its minimally invasive nature. Consistent with the literature, CTR-US provided faster recovery and improved patient comfort. However, mini-open surgery remains a reliable alternative with long-term symptom control and low complication rates. Our study found that both methods are effective, but CTR-US stands out for its esthetic and functional advantages.