Related Experiment Video
Updated: Aug 23, 2026
Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
[Pitfalls of endoscopic carpal tunnel release]
T Kretschmer1, G Antoniadis, W Börm
1Neurochirurgische Klinik der Universität Ulm am BKH Günzburg, Günzburg. kretschmerthomas@hotmail.com
Background:
The objective of this study was to evaluate the causes of failed endoscopic carpal tunnel release (CTR) in order to detect potentially hazardous operative steps. The intraoperative findings of 10 microsurgically revised cases were retrospectively analyzed.
Results:
From January 1999 to October 2001, ten patients underwent open revision surgery after being referred because of failed endoscopic carpal tunnel release (CTR). The median nerve had been injured in five cases, necessitating autologous sural nerve grafting in four. Two other patients underwent extensive (external and internal) neurolysis. The lesions were located twice in the main nerve trunk, three times in the recurrent motor branch, three times in a digital nerve, and once in the sensory palmar branch. The transverse carpal ligament (TCL) had not been sectioned in four cases and was incomplete in two. In another two cases, previously sectioned TCLs were closed again by firm fibrous tissue. In three cases, postoperative hematomas after the initial release were described and possibly contributed to symptoms.
Conclusion:
Endoscopic CTR in the hand of the inexperienced bears major risks for iatrogenic neurovascular injury.
