Tianhao Guo,1 Chenfei Li,1 Dehu Tian,1 Ruijiao Gao,2 Kunlun Yu,1 Naichao Sun,1 Jing Yang,1 Jiangbo Bai1 

1Department of Hand Surgery, Hebei Medical University Third Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China; 2Department of Vascular Surgery, Hebei Medical University Third Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China

Correspondence: Jiangbo Bai, Department of Hand Surgery, Hebei Medical University Third Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China, Email 38200387@hebmu.edu.cn

Study Design: A retrospective cohort study.
Objective: This study aimed to compare the effectiveness and safety of the new device-assisted mini-incision approach for carpal tunnel release (CTR) with the conventional method.
Methods: A total of 109 patients diagnosed with primary carpal tunnel syndrome confirmed clinically were retrospectively included and divided into two groups based on the surgical approach: Group A (n=54) underwent surgery using a new device-assisted mini-incision, and Group B (n=55) received conventional surgery. Clinical outcomes, including pinch strength, grip strength, Visual Analog Scale (VAS) score, two-point discrimination (2-PD), Disabilities of the Arm, Shoulder, and Hand (DASH) score, and Boston Carpal Tunnel Questionnaire (BCTQ), were evaluated at 1, 3, and 6 months postoperatively. Additionally, operative time, incision length, wound pain, pillar pain, and the interval until return-to-work were compared between the two groups.
Results: At the 6-month follow-up, all patients in both groups had recovered. There were no significant differences between the two groups in postoperative pinch strength (P = 0.665), grip strength (P = 0.803), 2-point discrimination (2-PD) (P = 0.347), Visual Analogue Scale (VAS) score (P = 0.143), Disabilities of the Arm, Shoulder and Hand (DASH) score (P = 0.524), and Boston Carpal Tunnel Questionnaire (BCTQ) (SSS: P = 0.195; FSS: P = 0.103). Statistically significant differences were observed between the two groups in operation time (P < 0.001), incision length (P < 0.001), and return to work time (P < 0.001). Although at 6-month follow-up, there was no significant difference in the incidence of wound pain and pillar pain between the two groups. But the incidence of wound pain and pillar pain was lower in Group A (wound pain: 0%; pillar pain:0%) compared to Group B (wound pain: 5.5%; pillar pain:7.3%).
Conclusion: The device-assisted mini-incision technique provided comparable functional results to the conventional approach, with reduced complications and smaller incisions, supporting its use as a viable alternative in appropriate cases.

Keywords: carpal tunnel syndrome, carpal tunnel release, mini-incision approach, conventional approach