Mehran Razavipour ^1* Sadegh Taheri ^1* Amirsaleh Abdollahi ^2* Yazdan Yahaghi ³

• ¹ Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
• ² Mazandaran University of Medical Sciences, Sari, Iran
• ³ . Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran, sari, Iran

In the open surgery of carpal tunnel syndrome, the Antebrachial Fascia was released historically. The benefit in releasing Antebrachial Fascia in CTS surgery is still controversial. So, this study was designed to evaluate this hypothesis. Methods: The study was designed as a two-arm randomized clinical trial study. Patients with the diagnosis of bilateral carpal tunnel syndrome enrolled in the study, and Patients under 18 years, with a history of carpal tunnel release, trauma to the spine, shoulder, or elbow, rheumatologic diseases, inflammatory arthropathy, and beginning the CTS in pregnancy were excluded from the study. The eligible patient's hands were randomly divided into two surgical groups. In the first group, the Antebrachial Fascia was opened to the proximal part, while in the second group, the fascia was opened from the central part of the deep layer to the distal volar part of the wrist. The pain severity, grip and pinch strength, symptom severity, and functional status were evaluated by visual analog scale (VAS)SAEHAN® hydraulic handgrip and pinch dynamometer and Boston Carpal Tunnel Questionnaire (BCTQ), respectively, at the baseline, one month, three months, and six months after surgery.Results: Finally, 230 patients (220 women and 10 men, 460 hands) completed the study. The mean age of patients was 50.4±8.4 years. In both groups of open surgery with and without the release of Antebrachial Fascia, the grip and pinch strength, BCTQ score, and pain severity were significantly improved at the end of the study (P<0.01), but there was no statistically significant difference between two groups (P>0.05). Patient satisfaction improved in both groups; also, no significant difference was observed between the two groups (P>0.05).Both open CTS surgery with and without Antebrachial Fascia release has the same clinical and functional outcomes. Therefore, avoiding the release of the Antebrachial Fascia preserves proprioception and prevents iatrogenic injury to the median nerve and its branches.Conversely, blunt release of the Antebrachial Fascia does not adversely affect the outcome.