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Endoscopic carpal tunnel release
1Department of Reconstructive Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Background:
Endoscopic carpal tunnel release was developed by Okutsu and Chow in 1989. Many reports have indicated that endoscopic carpal tunnel release diminishes postoperative pain and accelerates the recovery time.
Methods:
In a series of 1278 carpal tunnel release procedures (in 948 patients), 1214 were performed with a modified Menon endoscopic method and the remaining 64 with an open procedure. The patients with idiopathic carpal tunnel syndrome were followed for at least 3 months.
Results:
Of the endoscopic release patients, 80.9% recovered grip strength equal to or greater than preoperative levels within 4 weeks, whereas in the open procedure group, the rate was only 59.3%. The difference was statistically significant (p = 0.00011). An immediate complication was one median motor nerve severance. There were 24 conversions to a conventional open procedure during endoscopic release. In the endoscopic group, 81% developed scar tenderness over the thenar crease, 31% developed new sensory disturbance, and 4% developed pillar pain.
Conclusion:
Endoscopic release facilitated the recovery of grip strength and diminished the frequency of scar tenderness. However, neurovascular injury should be carefully prevented.