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Ultrasound-guided percutaneous carpal tunnel release: A systematic review.

OBJECTIVE
Carpal tunnel syndrome (CTS) is the most common peripheral entrapment mononeuropathy. The purpose of this systematic review is to evaluate the reported clinical effectiveness and safety of ultrasound-guided percutaneous carpal tunnel release (USCTR) for the treatment of CTS.


LITERATURE SURVEY
PubMed, EMBASE, and ScienceDirect databases were queried from database inception to February 20th , 2021 to identify clinical studies on USCTR.


METHODOLOGY
Two reviewers independently completed title, abstract, and full-text screening and extracted data in duplicate for analysis. Procedure techniques, outcome measures, and complications were descriptively analyzed.


SYNTHESIS
A total of 87 studies were eligible for screening. 20 studies (three randomized controlled trials, three prospective cohort studies, and 14 case series) met inclusion criteria, with a total of 1,772 USCTR cases. The overall level of evidence was very low, with seven studies with at least moderate risk of bias. Thirteen studies exceeded the minimal clinically important difference (MCID) for the Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-SS) and Boston Carpal Tunnel Questionnaire Functional Status Scale (BCTQ-FS), and six studies exceeded MCID for the Quick Disabilities of Arm, Shoulder & Hand (QDASH). Five studies reported statistically significant improvement in these functional outcome measures as early as the first week post-procedure. Major complication occurred in one patient who developed suspected compartment syndrome, and minor complications were reported in 24 patients.


CONCLUSIONS
Based on very low level of evidence, early studies suggest that USCTR may be an effective treatment for CTS, with potential for short post-procedure recovery times. This article is protected by copyright. All rights reserved.