Document Detail


Surgical treatment options for carpal tunnel syndrome.
MedLine Citation:
PMID:  17943805     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Carpal tunnel syndrome is a common disorder for which several surgical treatment options are available.
OBJECTIVES: To compare the efficacy of the various surgical techniques in relieving symptoms and promoting return to work or activities of daily living and to compare the occurrence of side-effects and complications in patients suffering from carpal tunnel syndrome.
SEARCH STRATEGY: We updated the searches in 2006. We conducted computer-aided searches of the Cochrane Neuromuscular Disease Group Trials Register (searched in June 2006), Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2006, Issue 2), MEDLINE (January 1966 to June 2006), EMBASE (January 1980 to June 2006) and also tracked references in bibliographies.
SELECTION CRITERIA: Randomised controlled trials comparing various surgical techniques for the treatment of carpal tunnel syndrome.
DATA COLLECTION AND ANALYSIS: Two review authors performed study selection, assessment of methodological quality and data extraction independently of each other.
MAIN RESULTS: Thirty-three studies were included in the review of which 10 were newly identified in this update. The methodological quality of the trials ranged from fair to good; however, the use of allocation concealment was mentioned explicitly in only seven trials. Many studies failed to present the results in sufficient detail to enable statistical pooling. Pooling was also impeded by the vast variety of outcome measures that were applied in the various studies. None of the existing alternatives to standard open carpal tunnel release offered significantly better relief from symptoms in the short- or long-term. In three studies with a total of 294 participants, endoscopic carpal tunnel release resulted in earlier return to work or activities of daily living than open carpal tunnel release, with a weighted mean difference of -6 days (95% CI -9 to -3 days).
AUTHORS' CONCLUSIONS: There is no strong evidence supporting the need for replacement of standard open carpal tunnel release by existing alternative surgical procedures for the treatment of carpal tunnel syndrome. The decision to apply endoscopic carpal tunnel release instead of open carpal tunnel release seems to be guided by the surgeon's and patient's preferences.
Authors:
R J P M Scholten; A Mink van der Molen; B M J Uitdehaag; L M Bouter; H C W de Vet
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2007-10-17
Journal Detail:
Title:  The Cochrane database of systematic reviews     Volume:  -     ISSN:  1469-493X     ISO Abbreviation:  Cochrane Database Syst Rev     Publication Date:  2007  
Date Detail:
Created Date:  2007-10-18     Completed Date:  2008-01-17     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  100909747     Medline TA:  Cochrane Database Syst Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  CD003905     Citation Subset:  IM    
Affiliation:
Academic Medical Center, Dutch Cochrane Centre, Room J1B - 108 - 1, P.O. Box 22700, Amsterdam, Netherlands, 1100 DE. r.j.scholten@amc.uva.nl
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MeSH Terms
Descriptor/Qualifier:
Carpal Tunnel Syndrome / surgery*
Humans
Randomized Controlled Trials as Topic
Comments/Corrections
Update Of:
Cochrane Database Syst Rev. 2004;(4):CD003905   [PMID:  15495070 ]

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