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The effect of epineurotomy on the median nerve volume after the carpal tunnel release: a prospective randomised double-blind controlled trial

International Orthopaedics volume 36, pages 1885–1892 (2012)Cite this article

Abstract

Purpose

The purpose of this study was to evaluate the effects of epineurotomy on the post-surgical median nerve volume and clinical outcomes in carpal tunnel syndrome (CTS) patients with a prominent nerve narrowing.

Methods

This was a prospective, randomised, double-blind controlled trial. Patients (n = 50) were randomised (1:1) to open-field surgical carpal tunnel release followed by a longitudinal epineurotomy of the nerve (test), or to open-field release without epineurotomy (control).

Results

The nerve volume was slightly larger in the test group 90 days post-surgery (by 10.5 %, p = 0.157) but not 180 days post-surgery. No relevant electropyhsiological or clinical difference between groups and no effect of the nerve volume was observed. The subjective pain reduction was slightly more prominent in the control group at 180 days. Larger post-surgical nerve volume was associated with lower pain, but only in the control group.

Conclusions

Even in selected CTS patients, longitudinal epineurotomy confers no benefit regarding the nerve volume or clinical outcomes over a simple carpal tunnel release.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, County General Hospital Požega, Osječka 107, 34000, Požega, Croatia

    Tomislav Crnković

  2. Department of Neurology, County General Hospital Požega, Požega, Croatia

    Marijan Cesarik

  3. Department of Radiology, County General Hospital Požega, Požega, Croatia

    Nikola Gotovac

  4. Department of Orthopedic Surgery, University Hospital Center “Zagreb” and Zagreb University School of Medicine, Zagreb, Croatia

    Ranko Bilić

  5. Zagreb University School of Medicine, Zagreb, Croatia

    Vladimir Trkulja

  6. Department of Trauma Surgery, University Hospital Center “Sestre Milosrdnice”, Zagreb, Croatia

    Robert Kolundžić

Authors
  1. Tomislav Crnković
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  2. Ranko Bilić
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  3. Vladimir Trkulja
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  4. Marijan Cesarik
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  5. Nikola Gotovac
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  6. Robert Kolundžić
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Correspondence to Tomislav Crnković.

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Crnković, T., Bilić, R., Trkulja, V. et al. The effect of epineurotomy on the median nerve volume after the carpal tunnel release: a prospective randomised double-blind controlled trial. International Orthopaedics (SICOT) 36, 1885–1892 (2012). https://doi.org/10.1007/s00264-012-1565-y

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  • DOI: https://doi.org/10.1007/s00264-012-1565-y

Keywords

  • Grip Strength
  • Median Nerve
  • Carpal Tunnel Syndrome
  • Carpal Tunnel
  • Carpal Tunnel Release