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Endoscopic carpal tunnel decompression
1Department of Plastic and Reconstructive Surgery, Charing Cross Hospital, London.
Journal of Hand Surgery (Edinburgh, Scotland)
|February 1, 1994
Summary
Endoscopic carpal tunnel release offers faster recovery and improved strength compared to open surgery. This study found endoscopic methods significantly reduce return-to-work time with varying complication rates depending on technique.
Area of Science:
- Orthopedics
- Surgical Innovation
- Hand Surgery
Background:
- Carpal tunnel syndrome (CTS) is a common condition causing median nerve compression.
- Open carpal tunnel release is the traditional surgical treatment.
- Endoscopic techniques offer potential minimally invasive advantages.
Purpose of the Study:
- To compare the efficacy and safety of endoscopic carpal tunnel release versus open release.
- To evaluate functional outcomes and return to work after both procedures.
Main Methods:
- The study included cadaveric dissections, a pilot study (20 patients), and a randomized trial (71 patients).
- Patients underwent either endoscopic or open carpal tunnel decompression.
- Simultaneous bilateral release was performed in some patients.
Main Results:
- Both endoscopic and open techniques effectively decompressed the median nerve.
- Endoscopic surgery led to significant improvements in grip and pinch strength over 3 months.
- Average return to work was 14 days for endoscopic vs. 39 days for open release.
- Complication rates varied: 35% (transbursal endoscopic), 3.7% (extrabursal endoscopic), and 13.5% (open).
Conclusions:
- Endoscopic carpal tunnel release is a viable alternative to open surgery, offering faster return to work and improved functional strength.
- The extrabursal endoscopic technique demonstrated a lower complication rate compared to transbursal endoscopic and open methods.