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Metacarpal Small Incision for Carpal Tunnel Syndrome
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Endoscopic Versus Open Carpal Tunnel Release.

Eon K Shin1

  • 1Philadelphia Hand to Shoulder Center, Thomas Jefferson University Hospital, 1203 Langhorne-Newtown Road, Suite 335, Langhorne, PA, 19047, USA. ekshin@handcenters.com.

Current Reviews in Musculoskeletal Medicine
|November 28, 2019
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Summary

Carpal tunnel surgery, using open or endoscopic methods, offers comparable safety and effectiveness. Endoscopic carpal tunnel release shows faster recovery and higher patient satisfaction, despite some concerns.

Keywords:
Carpal tunnel syndromeEndoscopic carpal tunnel surgeryNeuropraxiaOpen carpal tunnel surgeryReturn to work

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Area of Science:

  • Orthopedic Surgery
  • Neurosurgery
  • Hand Surgery

Background:

  • Carpal tunnel syndrome is a common compressive neuropathy.
  • Symptoms include paresthesias in the median nerve distribution, often causing nocturnal disturbances.
  • Surgical treatment involves dividing the transverse carpal ligament via open or endoscopic approaches.

Purpose of the Study:

  • To review the literature on current carpal tunnel surgery techniques.
  • To summarize the state of open versus endoscopic carpal tunnel release.
  • To compare the safety, efficacy, and patient outcomes of both surgical methods.

Main Methods:

  • Literature review of studies comparing open and endoscopic carpal tunnel surgery.
  • Analysis of reported functional outcomes, recovery times, complication rates, and patient satisfaction.
  • Synthesis of evidence regarding the safety and effectiveness of both surgical approaches.

Main Results:

  • Endoscopic techniques offer superior early functional outcomes and quicker recovery.
  • Concerns regarding nerve, vessel, and tendon injuries with endoscopic methods are not supported by literature.
  • Both open and endoscopic carpal tunnel surgery demonstrate similar complication rates.
  • Patients report higher satisfaction with endoscopic carpal tunnel release compared to open surgery.

Conclusions:

  • The debate between open and endoscopic carpal tunnel surgery persists.
  • Despite fewer surgeons using endoscopic techniques, evidence supports comparable safety and efficacy for both methods.
  • Endoscopic carpal tunnel release is associated with improved patient satisfaction and faster recovery.