Endoscopic Carpal Tunnel Release: 695 cases--a Single Surgeon’s Experience and a Review of the Literature

Fadi Abou-Nukta, MD

Jeffrey Arons, MD. FACS

Background:

Endoscopic Carpal tunnel release (ECTR) is a well-established technique for the treatment of carpal tunnel syndrome. Several randomized prospective studies have shown comparable results to the open release. In this report we review a single surgeon’s experience and review the literature.

Methods and Materials:

All patients who underwent ECTR by the senior author between 1995-2005 were included in the study. The diagnosis of carpal tunnel syndrome was confirmed by the history and physical exam. Electrophysiologic studies were performed on all patients. The single-portal Ageeä technique was used. The rate of complications, recurrence, persistence of symptoms, and conversion to the open technique were noted.

Results:

695 cases were identified. Ages ranged from 22-91 years old. There was no major nerve injury, including the median nerve, the motor branch of the median nerve, the digital nerves, or the ulnar nerve. There were no vascular injuries.

Four patients had recurrences (0.5%); 4 patients reported no change in symptoms; 7 patients had persistent pain after surgery; and 4 patients had to be converted to open during the early years of the study. Two patients had a reversible neuropraxia of the median nerve.

Conclusions:

Based on our experience and the relevant literature, endoscopic carpal tunnel release is a safe and effective approach for the treatment of carpal tunnel syndrome.

Published by the New England Hand Society 2005.