Systematic review of randomized clinical trials of surgical treatment for carpal tunnel syndrome

Background: Carpal tunnel syndrome (CTS) is a common disorder for which sev eral surgical treatment options are available. However, there is no consens us on the most effective method of treatment. The object of this systematic review is to compare the efficacy of the various surgical techniques in re lieving the symptoms of CTS and promoting return to work and/or activities of daily living. Methods: Computer-aided searches of Medline, EMBASE and the Cochrane Contro lled Trials Register were conducted, together with reference checking. A ra ting system, based on the number of studies and their methodological qualit y and findings, was used to determine the strength of the available evidenc e for the efficacy of the treatment. Results: Fourteen studies were included in the review. None of the alternat ives to standard open carpal tunnel release (OCTR) seems to offer better re lief of symptoms. There is conflicting evidence about whether endoscopic ca rpal tunnel release results in earlier return to work and/or activities of daily living. Conclusion: Standard OCTR is still the preferred method of treatment for CT S. It is just as effective as the alternatives, but is technically less dem anding, so incurs a lower risk of complications and of added costs.