Comparison of the results of surgical treatment of carpal tunnel syndrome using two variations of the open technique Thesis by Ana Carolina da Silva Lovato. Advisor: Patrícia Maria de Moraes Barros Fucs and Yussef Ali Abdouni

Introduction: Complete opening of the transverse carpal ligament (CTL) is the treatment of choice for carpal tunnel syndrome. Nonetheless, complications such as loss of grip strength and anterior displacement of the median nerve are described as common complications associated with this technique. Thus, techniques are described that reconstruct or extend the LTC to reduce the incidence of these complications. Objective: To evaluate the effectiveness of the enlargement of the LTC through zetaplasty and the reduction of complications comparing it with the complete opening of the ligament. Materials and methods: An intervention study, prospective and randomized in 56 patients. These were divided into 2 groups: 1) complete opening of the LTC 2) enlargement of the LTC through zetaplasty. We evaluated grip strength, sensitivity and functional assessment using the quick-DASH questionnaire. Results: There was no statistically significant difference in the improvement of scores with Quick-DASH between the two techniques. The sensitivity test was better in patients submitted to LTC enlargement, while the force of Prehension had a greater increase in the group submitted to complete opening of the CTL. Conclusion: According to the results of this work, the complete opening of the LTC did not lead to a reduction in grip strength, although it has been shown to inferior in recovery to sensitivity in the postoperative period. The two techniques were equivalent in functional improvement. In this way, we did not find identifiable benefits in carrying out zetaplasty for CTL enlargement.