Carpal tunnel release with and without epineurotomy: a comparative prospective trial

A prospective, comparative study of epineurotomy as an adjunctive procedure to transverse carpal ligament release for the treatment of carpal tunnel syndrome was conducted. Eighty-six patients with 117 involved hands were entered into the study. After entry, all patients completed an extensive preoperative questionnaire, a detailed physical examination, and preoperative neurophysiologic testing. Seventy-five hands were followed for a minimum of 24 months. The operative findings were similar between the group of those undergoing epineurotomy and the group that did not undergo epineurotomy. Postoperatively the twopoint discrimination values for all fingers averaged 5.3 mm and 5.15 mm, respectively, for the epineurotomy and nonepineurotomy groups. The physical findings, neurophysiologic findings, and patient perceptions of outcome after surgery were similar. It was concluded that the study data do not support the use of epineurotomy as an adjunctive procedure during carpal tunnel release.