Evaluation of Endoscopic Release for Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is the most common nerve entrapment disorder of the upper limb worldwide. Endoscopic carpal tunnel release (ECTR) has been widely applied to CTS and has achieved good results. Detailed postoperative outcomes of ERCT at different time points in the Chinese population are rare.

From January 2018 to December 2022, we collected and evaluated information from 186 patients (273 wrists) who received 2-port ECTR in a prospective cohort study. The Boston Carpal Tunnel Questionnaire, the visual analog pain scale, grip strength, pinch strength, the Semmes-Weinstein monofilament test, and 2-point discernment were used to evaluate postoperative recovery at preoperative, 3 weeks, 3 months, 6 months, 9 months, and 12 months postsurgery. We also recorded surgical complications, tenosynovitis, and patient satisfaction.

The male-to-female ratio reached 1 to 10.6. The most common age for CTS is 50-59 years (up 52.7%), and the average age was 52.1 years. The Boston Carpal Tunnel Questionnaire functional status scale and symptom severity scale showed significant improvement and lasted up to 12 months postsurgery. The pain was present after surgery and relieved within 6 months. Grip and pinch strength decreased at 3 weeks and recovered at 6 months after the operation. The Semmes-Weinstein monofilament test and 2-point discernment continued to improve and were stable 6 months after surgery. One vascular injury, 1 nerve injury, 10 cases of transient nerve paralysis, and 12 instances of columnar pain were recorded. There were no skin or wound-related complications. No revision carpal tunnel release was required. Ninety-one percent of patients were satisfied.

Patients who received ECTR had significant functional and symptom improvements with rare complications. The ECTR is a reliable and acceptable option for CTS.