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Endoscopic carpal tunnel release using the subligamentous two-portal technique
1University of Southern California School of Medicine, Los Angeles, California.
Contemporary Orthopaedics
|February 8, 1991
Summary
A modified endoscopic carpal tunnel release significantly reduced median nerve symptoms and eliminated postoperative nerve complications. This safe and effective surgical technique offers an alternative to open carpal tunnel surgery.
Area of Science:
- Orthopedics
- Neurosurgery
- Hand Surgery
Background:
- Carpal tunnel syndrome (CTS) is a common entrapment neuropathy of the median nerve.
- Surgical treatment for CTS aims to decompress the median nerve.
- Endoscopic carpal tunnel release (ECTR) using a two-portal technique has emerged as a less invasive option.
Purpose of the Study:
- To describe a subligamentous modification of the two-portal ECTR technique.
- To evaluate the safety and efficacy of this modified approach.
- To demonstrate the specialized instrumentation used in this procedure.
Main Methods:
- A series of 75 hands in 65 patients with symptomatic CTS underwent the modified subligamentous two-portal ECTR.
- The surgical technique and specialized tools were documented.
- Postoperative outcomes, including nerve complications and symptom relief, were assessed.
Main Results:
- In the initial phase, 8% of hands experienced transient ulnar nerve neuropraxia, and one patient had a median nerve laceration.
- Following the implementation of the subligamentous approach, no postoperative nerve complications were observed.
- The majority of patients reported a significant reduction in median nerve symptoms.
Conclusions:
- The subligamentous modification of the two-portal endoscopic carpal tunnel release is a safe procedure.
- This technique effectively alleviates median nerve symptoms associated with carpal tunnel syndrome.
- It offers comparable efficacy to open surgical treatment with a reduced risk of nerve complications.