Letter to Editor regarding "Comparison between single portal endoscopic and 1-cm open carpal tunnel release": Could the 1-cm open carpal tunnel release surgery miss space-occupying lesions?

Given the controversy about the best surgical technique for carpal tunnel release, this study tested the hypothesis that no significant differences would be observed between single-portal endoscopic release and a short, 1-cm incision open release in a large sample of patients. Consecutive patients were assigned to one of the two techniques. Preoperative and postoperative measurements included grip and pinch strength, a visual analog scale for pain and a satisfaction questionnaire. Eighty-seven patients completed the study: 35 with an endoscopic release and 52 with an open release. Both techniques were effective and safe: grip and pinch strength decreased 1 month after surgery in both techniques but improved significantly at 6 and 12 months (p < 0.05) while the complication rate was low. Subjective results were judged to be "excellent or good" by more than 90% of patients in both groups. No significant between-technique differences in outcomes were observed thus, surgical decisions may be based on criteria other than effectiveness. Level of evidence: Level IV; Case Series; Treatment Study.