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Updated: Apr 18, 2026
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Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
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Carpal Tunnel Release Surgical Techniques
Rayan El Bachaoui1, Brandon E Earp2, Philip E Blazar2
1Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA; Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium.
The Journal of Hand Surgery
|April 16, 2026
Summary
Carpal tunnel release (CTR) surgery offers definitive treatment for carpal tunnel syndrome. This review synthesizes evidence on open, endoscopic, and ultrasound-guided CTR techniques, comparing outcomes and future innovations.
Area of Science:
- Orthopedics
- Neurosurgery
- Surgical Innovation
Background:
- Carpal tunnel syndrome (CTS) is the most prevalent upper-extremity compressive neuropathy.
- Median nerve dysfunction arises from increased carpal tunnel pressure.
- Conservative treatments offer limited relief; surgical decompression is definitive.
Purpose of the Study:
- To provide an updated synthesis of evidence on various carpal tunnel release (CTR) surgical techniques.
- To compare outcomes, complications, and recovery trajectories of different CTR methods.
- To discuss current controversies and future directions in CTR.
Main Methods:
- Review of conventional open and mini-open CTR approaches.
- Examination of single- and dual-portal endoscopic CTR techniques.
- Discussion of ultrasound-guided CTR, including standard and thread-based methods.
Main Results:
- Comparative analysis of surgical outcomes, complication rates, and recovery.
- Evaluation of cost-effectiveness, anatomical variability, and sustainability.
- Presentation of clinical images illustrating technique nuances.
Conclusions:
- Surgical decompression is the definitive treatment for persistent carpal tunnel syndrome.
- Evidence synthesis supports informed choices among open, endoscopic, and ultrasound-guided CTR.
- Future innovations in CTR continue to evolve surgical management.
