Effectiveness of carpal tunnel syndrome rehabilitation after endoscopic versus open surgical release.

BACKGROUND. Carpal tunnel syndrome is a common upper limb compression neuropathy. Postoperative rehabilitation improves the function of the limb. The aim of this study was to assess the effects of rehabilitation in patients who had undergone endoscopic vs. open surgical carpal tunnel release. MATERIAL AND METHODS. Twenty-six patients were divided into endoscopy (E) and open surgery (K) groups. The following parameters were assessed after rehabilitation: two-point discrimination by fingertips of the operated hand, ranges of motion of joints of the hand, circumferences of the radiocarpal and metacarpo pha langeal joints and the severity of pain and other symptoms. RESULTS. The groups differed regarding the severity of symptoms (numbness), joint circumferences and tactile sensation in fingertips I-IV. The mean values of these parameters were significantly higher in group K compared to group E. In group E, rehabilitation decreased severity of pain and other symptoms and increased the ranges of motion. Recovery of two-point discrimination by fingertips I-IV was also observed. Group K patients showed the greatest improvement in the range of motion. Pain intensity decrease did not reach statistical significance. The two-point discrimination test demonstrated better tactile sensation, but the mean distance between caliper points for particular fingers still showed reduced two-point discrimination ability. CONCLUSIONS. 1. Rehabilitation improved hand function in patients from groups that operated on using different techniques of median nerve release. 2. Rehabilitation resulted in improved innervation density, which was reflected by changes in two-point discrimination scores in fingertips in the operated hand of patients from both groups. 3. Great er improvement was achieved in the pa tients who had undergone an endoscopic procedure.