On 2014 Mar 30, M Felix Freshwater commented:

I would appreciate the authors answering these questions: 1. They wrote: "The study protocol conformed to the ethical guidelines of the Declaration of Helsinki." Can they share with readers the name of the institutional whose review board approved the study? 2. Can they share with readers the trial registry and registration number for this study, which is a requirement of the Declaration of Helsinki? 3. Can they describe their randomization method? 4. Figure 1 is described as a preoperative view of the TOCTR, yet there are obvious suture marks and a scar that extends proximal to the wrist crease. Can the authors explain this and tell readers how many patients in each group were having repeat carpal tunnel surgery as the patient in figure 1 appears to have had? 5. Can the authors explain why the median nerve is shown as being lifted out of the wound in figure 2? Is this a routine part of their TOCTR procedure? If so this stretching of the nerve could be the etiology of the differences in their results. 6. They describe their MACTR incisions as being 2 cm. long while they describe their TOCTR incisions as “extended 2-4 cm proximally towards the wrist crease”. Figure 3 shows that the TOCTR incision extends an additional 2-4 cm. proximal to the wrist crease. Since both types of incisions began at Kaplan’s line, it appears that what they were comparing were the pain and appearance of a 2 cm scar vs. the pain and appearance of a 4-8 cm total length scar. I think that their findings were a foregone conclusion. What was the purpose of studying pain and appearance in two groups of scars whose length was twice to four times different?

On 2014 Mar 30, M Felix Freshwater commented:

I would appreciate the authors answering these questions: 1. They wrote: "The study protocol conformed to the ethical guidelines of the Declaration of Helsinki." Can they share with readers the name of the institutional whose review board approved the study? 2. Can they share with readers the trial registry and registration number for this study, which is a requirement of the Declaration of Helsinki? 3. Can they describe their randomization method? 4. Figure 1 is described as a preoperative view of the TOCTR, yet there are obvious suture marks and a scar that extends proximal to the wrist crease. Can the authors explain this and tell readers how many patients in each group were having repeat carpal tunnel surgery as the patient in figure 1 appears to have had? 5. Can the authors explain why the median nerve is shown as being lifted out of the wound in figure 2? Is this a routine part of their TOCTR procedure? If so this stretching of the nerve could be the etiology of the differences in their results. 6. They describe their MACTR incisions as being 2 cm. long while they describe their TOCTR incisions as “extended 2-4 cm proximally towards the wrist crease”. Figure 3 shows that the TOCTR incision extends an additional 2-4 cm. proximal to the wrist crease. Since both types of incisions began at Kaplan’s line, it appears that what they were comparing were the pain and appearance of a 2 cm scar vs. the pain and appearance of a 4-8 cm total length scar. I think that their findings were a foregone conclusion. What was the purpose of studying pain and appearance in two groups of scars whose length was twice to four times different?