Predictive Factors for Converting Endoscopic to Open Carpal Tunnel Release.

Area of Science:

• Orthopedic Surgery
• Minimally Invasive Procedures

Background:

• Carpal tunnel release can be performed using open or endoscopic techniques.
• Endoscopic carpal tunnel release offers potential benefits like smaller incisions.
• Determining factors for conversion from endoscopic to open surgery is crucial for patient selection and surgical planning.

Purpose of the Study:

• To determine the overall conversion rate from endoscopic to open carpal tunnel release.
• To identify patient-specific or procedural factors that predict conversion during endoscopic carpal tunnel surgery.

Main Methods:

• A retrospective chart review of 1053 attempted endoscopic carpal tunnel releases was conducted over a 9-year period.
• Data collected included patient demographics, comorbidities, and surgical details.
• Statistical analysis (chi-square test) was used to identify significant predictive factors for conversion.

Main Results:

• The overall endoscopic to open carpal tunnel release conversion rate was 4.27% (45 out of 1053 cases).
• No statistically significant predictive risk factors for conversion were identified, including age, sex, BMI, EMG severity, wrist arthritis, steroid injections, trainee surgeon, diabetes, or hand dominance.
• Nineteen of the 45 converted cases proceeded to successful contralateral endoscopic release.

Conclusions:

• The conversion rate from endoscopic to open carpal tunnel release is relatively low.
• No identifiable patient or procedural factors reliably predict conversion.
• Previous conversion to open surgery does not preclude successful future endoscopic release on the contralateral side.