{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:18:54Z","timestamp":1790270334728,"version":"4.1.0"},"reference-count":35,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:00:00Z","timestamp":1745539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The aim of this study was to compare the short- and long-term effectiveness of ultrasound-guided percutaneous release (CTR-US) and mini-open surgery in the treatment of carpal tunnel syndrome (CTS). Materials and Methods: A retrospective analysis was conducted on 172 patients who underwent surgical treatment for CTS between 2015 and 2020. The patients were divided into two groups: those who underwent CTR-US (Group A, n = 66) and those treated with mini-open surgery (Group B, n = 106). All patients were evaluated using the Boston Carpal Tunnel Questionnaire (BCTQ) and the Quick Disabilities of the Arm, Shoulder, and Hand (QDASH) scores before surgery and at 3 months, 6 months, 1 year, 2 years, and 5 years postoperatively. Electrophysiological and ultrasound findings were also compared. Statistical analyses were performed using t-tests, Mann\u2013Whitney U tests, and Chi-square tests, with significance set at p &lt; 0.05. Results: A total of 172 patients who met the study criteria were included. Among the participants, 112 were women and 60 were men. The mean age was calculated as 61 years for female patients and 54 years for male patients. No significant differences were found between the groups in terms of age, gender, laterality, and disease duration. Both groups demonstrated significant improvements in BCTQ and QDASH scores at all postoperative time points compared to preoperative scores (p &lt; 0.001). The CTR-US group showed advantages in shorter treatment duration (p &lt; 0.001), lower cost (p &lt; 0.05), and faster recovery time. Electrophysiological evaluations revealed faster improvements in distal motor latency (DML) and sensory conduction velocity (SCV) in the CTR-US group (p &lt; 0.05). Ultrasound assessments indicated that both methods achieved effective release of the transverse carpal ligament. No significant differences were observed between the groups in long-term questionnaire scores. Conclusion: CTR-US offers advantages such as shorter treatment duration, lower cost, and faster recovery due to its minimally invasive nature. Consistent with the literature, CTR-US provided faster recovery and improved patient comfort. However, mini-open surgery remains a reliable alternative with long-term symptom control and low complication rates. Our study found that both methods are effective, but CTR-US stands out for its esthetic and functional advantages.<\/jats:p>","DOI":"10.3390\/medicina61050799","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T10:42:09Z","timestamp":1745577729000},"page":"799","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Ultrasound-Guided Percutaneous Release and Mini-Open Surgery in Carpal Tunnel Syndrome: A Comparison of Short- and Long-Term Outcomes"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2348-8339","authenticated-orcid":false,"given":"\u0130brahim","family":"Ulusoy","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Turkey Selahaddin Eyyubi State Hospital, Diyarbak\u0131r 21070, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1366-9163","authenticated-orcid":false,"given":"Mehmet","family":"Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Gaziantep City Hospital, Gaziantep 27100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4586-3529","authenticated-orcid":false,"given":"Mehmet F\u0131rat","family":"Tantekin","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Turkey Selahaddin Eyyubi State Hospital, Diyarbak\u0131r 21070, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2740-4139","authenticated-orcid":false,"given":"\u0130smail","family":"G\u00fczel","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Malatya Turgut \u00d6zal University, Malatya 44070, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0657-2213","authenticated-orcid":false,"given":"Aybars","family":"K\u0131vrak","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Adana Avrupa Hospital, Adana 01100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1016\/S1474-4422(16)30231-9","article-title":"Carpal tunnel syndrome: Clinical features, diagnosis, and management","volume":"15","author":"Padua","year":"2016","journal-title":"Lancet Neurol."},{"key":"ref_2","first-page":"e7333","article-title":"Carpal Tunnel Syndrome: A Review of Literature","volume":"12","author":"Genova","year":"2020","journal-title":"Cureus"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Feng, B., Chen, K., Zhu, X., Ip, W.-Y., Andersen, L.L., Page, P., and Wang, Y. (2021). Prevalence and risk factors of self-reported wrist and hand symptoms and clinically confirmed carpal tunnel syndrome among office workers in China: A cross-sectional study. BMC Public Health, 21.","DOI":"10.1186\/s12889-020-10137-1"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1016\/j.jhsg.2023.06.012","article-title":"Management of Acute Carpal Tunnel Syndrome: A Systematic Review","volume":"5","author":"Ku","year":"2023","journal-title":"J. Hand Surg. Glob. Online"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Elnady, B., Rageh, E.M., Ekhouly, T., Fathy, S.M., Alshaar, M., Fouda, E.S., Attar, M., Abdelaal, A.M., El Tantawi, A., and Algethami, M.M. (2019). Diagnostic potential of ultrasound in carpal tunnel syndrome with different etiologies: Correlation of sonographic median nerve measures with electrodiagnostic severity. BMC Musculoskelet. Disord., 20.","DOI":"10.1186\/s12891-019-3010-5"},{"key":"ref_6","first-page":"349","article-title":"Clinical Results of Carpal Tunnel Release Using Ultrasound Guidance in Over 100 Patients at Two to Six Years","volume":"6","author":"Cano","year":"2024","journal-title":"J. Hand Surg. Glob. Online"},{"key":"ref_7","first-page":"1691","article-title":"Risk factors associated with the reported scores on symptoms severity and functional limitations scales of the Boston Carpal Tunnel Questionnaire: A cross-sectional study","volume":"85","author":"Sarhan","year":"2023","journal-title":"Br. J. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"15720","DOI":"10.30829\/contagion.v5i3.15720","article-title":"The effect of work factors moderated by individual factors on carpal tunnel syndrome (CTS) in tea harvesters at PTPN IV Sidamanik","volume":"5","author":"Wardani","year":"2023","journal-title":"Contagion"},{"key":"ref_9","first-page":"15525","article-title":"Dentist: Wrist position, handgrip strength, and body mass index associated with carpal tunnel syndrome in daily practice","volume":"6","author":"Ariyani","year":"2024","journal-title":"Manuju"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"460","DOI":"10.2214\/AJR.20.24383","article-title":"Minimally Invasive Ultrasound-Guided Carpal Tunnel Release Improves Long-Term Clinical Outcomes in Carpal Tunnel Syndrome","volume":"217","author":"Kamel","year":"2021","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1002\/pmrj.12801","article-title":"Ultrasound-guided percutaneous carpal tunnel release: A systematic review","volume":"15","author":"Chou","year":"2023","journal-title":"PM R"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1093\/bjr\/tqae189","article-title":"Ultrasound-Based Grading of Carpal Tunnel Syndrome: A Comparative Study of Cross-Sectional Area and Shear Wave Elastography at Different Wrist Joint Angles","volume":"98","author":"Zou","year":"2024","journal-title":"Br. J. Radiol."},{"key":"ref_13","first-page":"5685","article-title":"Ultrasound vs Nerve Conduction Studies: A Comparative Analysis in Carpal Tunnel Syndrome Diagnosis","volume":"8","author":"Haddani","year":"2024","journal-title":"Biosci. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"719","DOI":"10.52403\/ijrr.20240679","article-title":"Accuracy of Ultrasonography Diagnostic Tests in Carpal Tunnel Syndrome (Electromyography-Nerve Conduction Velocity as Gold Standard)","volume":"11","author":"Deriano","year":"2024","journal-title":"Int. J. Res. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1055\/s-0044-1790561","article-title":"Multiparametric Ultrasound Assessment of Carpal Tunnel Syndrome: Beyond Nerve Cross-sectional Area","volume":"28","author":"Albano","year":"2024","journal-title":"Semin. Musculoskelet. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Peters, S., Page, M.J., Coppieters, M.W., Ross, M., and Johnston, V. (2013). Rehabilitation following carpal tunnel release. Cochrane Database Syst Rev., CD004158.","DOI":"10.1002\/14651858.CD004158.pub2"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"4753","DOI":"10.1007\/s00402-024-05560-7","article-title":"Clinical-applied anatomy of the carpal tunnel regarding mini-invasive carpal tunnel release","volume":"144","author":"Kaiser","year":"2024","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_18","first-page":"e66899","article-title":"Percutaneous ultrasound-assisted carpal tunnel release using Sono-Instruments\u00ae","volume":"16","author":"Moungondo","year":"2024","journal-title":"Cureus"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"24050005","DOI":"10.69598\/sehs.18.24050005","article-title":"Modified mini-incision surgery for carpal tunnel syndrome: Technique and clinical outcome","volume":"18","author":"Malisorn","year":"2024","journal-title":"Sci. Eng. Health Stud."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1007\/s11547-025-01952-w","article-title":"Ultrasound-guided minimally invasive thread release of carpal tunnel: A cadaveric study","volume":"130","author":"Jengojan","year":"2025","journal-title":"Radiol Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"383","DOI":"10.21037\/qims-24-1410","article-title":"Comparison of ultrasound and magnetic resonance imaging of the median nerve\u2019s recurrent motor branch and the value of its diameter in diagnosing carpal tunnel syndrome","volume":"15","author":"Wang","year":"2025","journal-title":"Quant Imaging Med. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1002\/jcu.23019","article-title":"Minimally invasive ultrasound-guided vs open release for carpal tunnel syndrome in working population: A randomized controlled trial","volume":"49","author":"Aramendi","year":"2021","journal-title":"J. Clin. Ultrasound"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1002\/jum.15120","article-title":"Clinical Results of Ultrasound-Guided Carpal Tunnel Release Performed by a Primary Care Sports Medicine Physician","volume":"39","author":"Joseph","year":"2020","journal-title":"J. Ultrasound Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2699","DOI":"10.1002\/jum.14618","article-title":"Minimally Invasive Ultrasound-Guided Carpal Tunnel Release: Preliminary Clinical Results","volume":"37","author":"Henning","year":"2018","journal-title":"J. Ultrasound Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1097\/PHM.0000000000000652","article-title":"Evaluation of the Effectiveness and Safety of Ultrasound-Guided Percutaneous Carpal Tunnel Release: A Cadaveric Study","volume":"96","author":"Burnham","year":"2017","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"292","DOI":"10.5435\/JAAOS-D-21-00949","article-title":"Endoscopic Carpal Tunnel Release: Techniques, Controversies, and Comparison to Open Techniques","volume":"30","author":"Hacquebord","year":"2022","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_27","first-page":"42","article-title":"Clinical outcome of endoscopically assisted mini-open carpal tunnel release","volume":"30","author":"Iijima","year":"2024","journal-title":"J. Hand Surg."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Krieger, Y., Ofri, M., Moshe-Noach, H., Raiden, P., Shoham, Y., Sagi, A., Reiner-Benaim, A., and Silberstein, E. (2024). Long-term functional outcomes and quality of life following carpal tunnel release surgery. Int. J. Environ. Res. Public Health, 21.","DOI":"10.3390\/ijerph21091203"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e5665","DOI":"10.1097\/GOX.0000000000005665","article-title":"Final 1-year results of the TUTOR randomized trial comparing carpal tunnel release with ultrasound guidance to mini-open technique","volume":"12","author":"Eberlin","year":"2024","journal-title":"Plast. Reconstr. Surg. Glob. Open"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1177\/17531934211051276","article-title":"Return to work following ultrasound guided thread carpal tunnel release versus open carpal tunnel release: A comparative study","volume":"47","author":"Asserson","year":"2022","journal-title":"J. Hand Surg. (Eur. Vol.)"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Kim, I.J., and Kim, J.M. (2024). Long-Term Outcomes of Ultrasound-Guided Thread Carpal Tunnel Release and Its Clinical Effectiveness in Severe Carpal Tunnel Syndrome: A Retrospective Cohort Study. J. Clin. Med., 13.","DOI":"10.3390\/jcm13010262"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.1016\/j.jhsa.2013.05.016","article-title":"Clinical outcomes of endoscopic carpal tunnel release in patients 65 and over","volume":"38","author":"Beck","year":"2013","journal-title":"J. Hand Surg. Am."},{"key":"ref_33","first-page":"CD008265","article-title":"Endoscopic release for carpal tunnel syndrome","volume":"2014","author":"Vasiliadis","year":"2014","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1002\/jum.15146","article-title":"Ultrasound (US) Changes in the Median Nerve Cross-Sectional Area After Microinvasive US-Guided Carpal Tunnel Release","volume":"39","author":"Chappell","year":"2020","journal-title":"J. Ultrasound Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.jbspin.2017.11.003","article-title":"Treatment of carpal tunnel syndrome: From ultrasonography to ultrasound guided carpal tunnel release","volume":"85","author":"Petrover","year":"2018","journal-title":"Jt. Bone Spine"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/5\/799\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:21:44Z","timestamp":1760030504000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/5\/799"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,25]]},"references-count":35,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["medicina61050799"],"URL":"https:\/\/doi.org\/10.3390\/medicina61050799","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,25]]}}}