Endoscopic carpal tunnel release in a community-based series

Area of Science:

• Orthopedics
• Surgical Innovation

Background:

• Carpal tunnel syndrome (CTS) is a common condition causing hand pain and numbness.
• Traditional open release surgery has established outcomes and complication profiles.
• Endoscopic techniques aim to minimize surgical invasiveness and improve patient recovery.

Purpose of the Study:

• To establish a baseline for outcomes and complications of endoscopic carpal tunnel release (ECTR) in a community setting.
• To compare the efficacy and safety of ECTR using the Inside Job protocol against conventional methods.
• To analyze factors contributing to varied patient outcomes post-ECTR.

Main Methods:

• Retrospective analysis of 61 patients undergoing ECTR.
• Adherence to the Inside Job protocol for surgical technique.
• Assessment of outcomes based on excellent, good, and poor ratings.
• Evaluation of postoperative morbidity, return to work, pillar pain, scar tenderness, and neurological deficits.

Main Results:

• Excellent outcomes were achieved in 37 cases, good in 11, and poor in 4.
• ECTR demonstrated decreased postoperative morbidity and a quicker return to work.
• Analysis identified pillar pain, scar tenderness, and persistent numbness as factors influencing outcomes.
• One patient required median nerve repair; another underwent conversion to open release.

Conclusions:

• Endoscopic carpal tunnel release generally reduces morbidity and facilitates a faster return to work.
• The specific Inside Job device, as utilized in this study, did not provide sufficient justification for its continued use over conventional carpal tunnel release.
• Further research may be needed to optimize endoscopic techniques and device selection for carpal tunnel syndrome.