BACKGROUND: In this study, it was aimed to determine whether median nerve 
epineurectomy is beneficial in the surgical management of carpal tunnel syndrome 
(CTS).
MATERIALS AND METHODS: The study enrolled 72 patients including 34 patients 
without epineurectomy (Group A) and 38 patients with epineurectomy (Group B). 
Surgery was performed in patients with severe electrodiagnostic CTS findings, 
CTS duration >1 year and flattening along with hypervascularization in median 
nerve. All patients were assessed by visual analog scale, two-point 
discrimination test as well as subjective and objective findings at baseline and 
on the months 1, 3, and 6 after surgery.
RESULTS: The mean age was 58.3 years (42-75 years) in 38 patients who underwent 
an epineurectomy, whereas it was 61.5 years (41-82 years) in 34 patients who did 
not have an epineurectomy. The groups were similar with regard to age, gender, 
duration of symptoms, and preoperative physical findings. Mean visual analog 
scale (VAS) scores were 1.7 in Group A and 1.8 in Group B. Again, these 
differences were not significant, on physical examination, the average two-point 
discrimination in the distribution of the median nerve was 4.9 mm (range: 3-11 
mm) in Group A and 5.3 mm (range: 3-10 mm) in Group B. In postoperative 
evaluations, there was a better improvement in visual analog scale scores, 
two-point discrimination test and subjective symptoms including dysesthesia, 
pain and nocturnal pain within first 3 months; however, there was no marked 
difference in objective and subjective findings on the 6th month. No 
complication or recurrence was observed.
CONCLUSION: We believe that median nerve epineurectomy is unnecessary in the 
surgical management of primary CTS since it has no influence on the midterm 
outcomes.