Impact of ultrasound-guided percutaneous flexor retinaculum fenestration on outcome of hydrostatic dissection of median nerve in patient with carpal tunnel syndrome

Background Most cases of entrapment neuropathy are due to median nerve compression, which manifests most commonly as carpal tunnel syndrome (CTS). There are several nonsurgical treatment options available for mild-to-moderate circumstances. Aim To assess the effect of ultrasound-guided percutaneous flexor retinaculum fenestration on the outcome of hydrostatic dissection of the median nerve in cases with CTS. Methods This randomized clinical research included a total of 54 individuals with CTS separated into two groups; group (A) included patients with hydrostatic dissection with adjuvant fenestration of transverse carpal ligament ( n = 27), while group (B) involved patients with hydrostatic dissection alone ( n = 27). Pain and disability through the visual analog scale (VAS), symptom severity (SS) score, modified Boston Carpal Tunnel Questionnaire (BCTQ), and functional disability (FD) score before injection and 3 months post-injection were assessed. Distal motor latency (DML) and sensory conduction velocity (SCV) were measured at baseline and 3 months after the procedure. Results SS and FD scores, were comparable in both groups before the procedure, while after three months of the procedure, the mean of SS and FD scores was significantly higher in group A (24.18 ± 3.62 and 17.52 ± 2.15, respectively) than in group B (16.55 ± 3.17and 11.39 ± 1.81, respectively) ( p