Outcomes of Open Carpal Tunnel Decompression via Mini-Palm Incision: A Prospective Case Series from Misrata Medical Center, Libya

Abstract

Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy worldwide, and open surgical decompression via a mini-palm incision has gained wide acceptance as an effective treatment for moderate-to-severe CTS. This study aimed to evaluate the short-term surgical outcomes, complications, and patient satisfaction following open carpal tunnel decompression via mini-palm incision at Misrata Medical Center, Libya. A prospective cross-sectional study was conducted at Misrata Medical Center during 2018. Fifty-five patients underwent open carpal tunnel decompression via mini-palm incision; 51 patients who completed follow-up at 2 weeks and 3 months were included, and outcomes were assessed in terms of wound complications, surgical adequacy, and patient satisfaction at 3 months postoperatively. The study population was predominantly female (98.04%) with a mean age of 47.96 years. Complications occurred in 3 cases (5.88%): one incomplete decompression requiring revision surgery, and two superficial wound infections in diabetic patients, both managed conservatively. Forty-eight cases (94.12%) were complication-free, and no nerve injury, deep wound infection, wound dehiscence, vascular injury, or complex regional pain syndrome was recorded. At 3 months, 49 patients (96.08%) reported being satisfied with surgical outcomes and 2 (3.92%) were fairly satisfied. Open surgical decompression via mini-palm incision is a safe, effective, and technically accessible procedure for the treatment of moderate-to-severe CTS, yielding excellent short-term outcomes and very high patient satisfaction. Diabetic patients require heightened postoperative wound surveillance.