Purpose This study compared postoperative complications and revision rates following endoscopic versus open carpal tunnel release (CTR) in obese and nonobese patients. Methods A 2010–2022 national administrative database was queried to identify adults undergoing open or endoscopic CTR. Patients undergoing open and endoscopic CTR were each matched 1:1 for age, sex, diabetes, tobacco use, and Elixhauser Comorbidity Index in both the obese (body mass index > 30 kg/m2) and nonobese cohorts. Ninety-day complications and ipsilateral revision surgery within 5 years were compared using univariable and multivariable analysis for each cohort. Results In the obese matched cohort, endoscopic CTR was associated with lower rates of surgical site infection (0.46% vs 0.73%) and wound dehiscence (0.39% vs 0.72%) compared with open CTR (all P P = .466). On multivariable analysis, these associations remained significant (surgical site infection OR 0.62, 95% confidence interval CI 0.49–0.76 and wound dehiscence OR 0.53, 95% CI 0.42–0.67, all P P P = .007) for nonobese patients. There were no differences in hematoma or median nerve injuries in either cohort. Conclusions Endoscopic CTR was associated with a decrease in wound complications in both obese and nonobese patients. There were comparable rates of revision surgery and median nerve injuries between the 2 surgical approaches. However, the clinical differences were modest, and the choice of surgical approach may remain at the discretion of the treating surgeon. Type of study/level of evidence Therapeutic IIb (Oxford CEBM Level 2b. Retrospective comparative cohort study)
Salib et al. (Mon,) studied this question.