, Volume 9, Issue 1, pp 36–42

Prospective randomized comparison of single-incision and two-incision carpal tunnel release outcomes

Surgery Articles

DOI: 10.1007/s11552-013-9572-z

Cite this article as:
Castillo, T.N. & Yao, J. HAND (2014) 9: 36. doi:10.1007/s11552-013-9572-z



This study analyzes both the subjective and objective symptom and functional outcomes of patients who underwent either traditional single-incision or two-incision carpal tunnel release (CTR).


From 2008 to 2009, patients with isolated carpal tunnel syndrome were randomized to undergo either single-incision or two-incision CTR by a single surgeon at a university medical center. Pre-operatively, participants completed a Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire, Brigham and Women's Carpal Tunnel Questionnaire (BWCTQ), as well as grip and pinch strength and Semmes–Weinstein monofilament sensation testing. At 2 weeks, 6 weeks and at least 6 months post-operatively, these measurements were repeated along with assessment of scar tenderness and pillar pain. Data were analyzed using SPSS version 20 software to perform non-parametric tests and Pearson's correlations. Significance was set at p = 0.05.


There was no statistically significant difference between the single- and two-incision CTR groups with respect to pre- and post-operative DASH scores, BWCTQ scores, grip strength, pinch strength, scar tenderness, or pillar pain. The only statistically significant difference was improved sensation by Semmes–Weinstein in the single-incision group in the second finger at 6 weeks post-operatively and in the third finger at 6 months post-operatively.


The preservation of the superficial nerves and subcutaneous tissue between the thenar and hypothenar eminences may account for reports of less scar tenderness and pillar pain among recipients of two-incision CTR compared to single-incision CTR in the early post-operative period. However, there is similar post-operative recovery and improvement in grip and pinch strength and sensation after 6+ months post-operatively.


Carpal tunnel syndromeCarpal tunnel releaseDASH QuestionnaireBrigham and Women's Carpal Tunnel QuestionnaireTwo-incision carpal tunnel releaseMinimally-invasive carpal tunnel release

Copyright information

© American Association for Hand Surgery 2013

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryStanford University School of MedicinePalo AltoUSA
  2. 2.Department of Orthopaedic SurgeryStanford UniversityRedwood CityUSA