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Updated: Oct 1, 2025
04:08
Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
691
Endoscopic Carpal Tunnel Release: Techniques, Controversies, and Comparison to Open Techniques
Jacques H Hacquebord1, Jeffrey S Chen, Michael E Rettig
1From the Department of Orthopedic Surgery, New York University Langone Orthopedic Hospital (Hacquebord, Chen, and Rettig), NYU Langone Health, New York, NY.
Summary
Endoscopic carpal tunnel release (ECTR) offers comparable long-term effectiveness to open surgery for carpal tunnel syndrome. While ECTR presents a higher risk of temporary nerve injury, it allows for an earlier return to work.
Area of Science:
- Orthopedic Surgery
- Minimally Invasive Procedures
- Hand Surgery
Background:
- Carpal tunnel syndrome (CTS) is a common condition causing hand numbness and pain.
- Open carpal tunnel release (OCTR) is a traditional surgical treatment.
- Endoscopic carpal tunnel release (ECTR) is an increasingly popular alternative.
Purpose of the Study:
- To compare the effectiveness and outcomes of ECTR versus OCTR.
- To analyze complication rates, functional recovery, and cost-effectiveness.
Main Methods:
- Review of existing literature comparing ECTR and OCTR techniques.
- Classification of ECTR into single-portal and two-portal, antegrade and retrograde designs.
- Analysis of patient outcomes, including symptom relief, nerve injury, wound complications, and return to work.
Main Results:
- ECTR demonstrates equal efficacy to OCTR in symptom alleviation and long-term outcomes.
- ECTR is associated with a higher risk of transient nerve injury.
- OCTR has a greater risk of wound and scar complications.
- ECTR incurs higher direct costs but facilitates an earlier return to work.
Conclusions:
- ECTR is a safe and effective treatment for carpal tunnel syndrome when performed by experienced surgeons.
- The choice between ECTR and OCTR depends on balancing risks, benefits, and patient-specific factors.
- ECTR offers advantages in terms of faster return to work, despite potential nerve-related complications.
