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Journal of Hand Surgery (British and European Volume)
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Articles

Early Outcome and Cost-Effectiveness of Endoscopic Versus Open Carpal Tunnel Release: A Randomized Prospective Trial

N. L. B. SAW
S. JONES
L. SHEPSTONE
M. MEYER
P. G. CHAPMAN
A. M. LOGAN

From the Departments of Orthopaedic and Plastic Surgery, Norfolk and Norwich University Hospital, Norwich, UK

Correspondence: Mr. N.L.B. Saw, 54 Department of Orthopaedic Surgery, Norfolk & Norwich University Hospital, Colney Lane, Norwich NR4 7UY, UK. Tel.: +44-07747 777 082; E-mail: n_saw{at}hotmail.com.

Proponents of endoscopic carpal tunnel release have been advocating the technique for more than 10 years but there is still debate about its efficacy, safety and cost-effectiveness. We have performed a randomized, prospective, blind trial to compare early outcome after single portal endoscopic or open carpal tunnel surgery and to assess the cost-effectiveness of the procedures. There were no significant differences in symptom and functional activity scores, grip strength or anterior carpal pain in the first 3 months. For those in employment, we found a statistically significant difference between the two treatment groups with the endoscopic group returning to work, on average, 8 (95% CI, 2–13 days) days sooner than the open group. This translates into a cost saving to industry. There were no major neurovascular complications in either group. On the basis of these findings, we recommend that endoscopic carpal tunnel release should be considered in the employed as a cost-effective procedure, but perhaps not in the general population as a whole.

Key Words: endoscopic carpal tunnel release • cost-effectiveness

Journal of Hand Surgery (British and European Volume), Vol. 28, No. 5, 444-449 (2003)
DOI: 10.1016/S0266-7681(03)00097-4
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