A meta-analysis of clinical outcomes of limited wrist invasion versus limited palmar invasion for the treatment of carpal tunnel syndrome

Objective To evaluate the efficacy of carpal tunnel release with small incision in wrist and palm for the treatment of carpal tunnel syndrome using evidence-based medicine method. Methods PubMed, Cochrane Library, EMBASE, CBM, CNKI and Wanfang databases were searched by computer for relevant studies from their establishment to March 2018. References of relevant articles were checked for additional articles. All relevant randomized controlled trials were collected and the methodological quality of the included studies was evaluated. Revman 5.3 software was used for meta-analysis to obtain the evidence of differences in the efficacy of carpal tunnel release through wrist and palm incisions in the treatment of carpal tunnel syndrome. Results Five randomized controlled trials were included for evaluation. Meta-analysis showed that there was no significant difference in BCTQ postoperative symptom score and operation time between wrist incision group and palm incision group (P>0.05). The BCTQ postoperative functional score and incidence of scar discomfort in wrist incision group were better than those in palm incision group (P<0.05). Conclusion Compared with the palm incision group, the wrist incision group has some advantages in promoting functional recovery and reducing the incidence of scar discomfort, but it still needs a large sample of high-quality randomized controlled trials to verify the results of this analysis. Key words: Carpal tunnel syndrome; Meta-analysis; Limited invasion; Randomized controlled trials