A comparative meta-analysis of mini-transverse versus longitudinal techniques in the treatment of carpal tunnel syndrome.

Abstract

Background: Carpal tunnel syndrome (CTS) is a common nerve entrapment condition, and there is ongoing debate regarding the superiority of traditional open versus minimally invasive carpal tunnel surgery.

Methods: This meta-analysis reviewed six studies involving 478 patients to compare recovery and functional outcomes between the traditional longitudinal technique and the minimally invasive mini-transverse technique. The primary outcomes included the functional status scale (FSS), symptoms severity scale (SSS), pain scores, time to return to work, duration of operation, and incidence of complications.

Results: The mini-transverse technique was associated with lower FSS and SSS scores compared to the longitudinal technique, with mean differences (MD) of -0.32 (95% confidence level [CI]: -0.52, -0.12, P = 0.002) and -0.43 (95%CI: -0.6, -0.25, P < 0.00001), respectively. Pain scores were also lower with the mini-transverse technique (MD) of -0.5 (95%:CI: -0.71, -0.3, P < 0.00001). The mini-transverse group had a statistically significant shorter time to return to work (MD) of -8.34 (95%CI: -13.55, -3.13, P = 0.002). No significant differences were found in the duration of surgery (MD) of -6.96 (95%CI: -16.66, 2.74, P = 0.16) or incidence of complications (MD) of 0.46 (95%CI: 0.15, 1.4, P = 0.17).

Conclusion: The mini-transverse approach for CTS resulted in better outcomes, including less pain, faster recovery, and improved hand function. There was no significant difference in surgery time or complications compared to the traditional technique, suggesting it may be the preferable option.