A single-blind, randomized, controlled trial was done to compare the results of carpal tunnel release using classic incision, short incision, or endoscopic technique. In total, 90 consecutive cases were included. Follow-up was 24 weeks. We found a significantly shorter sick leave in the endoscopic group. No significant differences in pain, paraesthesiae, range of motion, pillar pain, and grip strength could be found at 24 weeks of follow-up, although intermediate significant differences were seen, especially in grip strength, in favour of endoscopic technique. No major advantage to using a short incision could be found. There were no serious complications in either group. The results indicate that the endoscopic procedure is safe and has the benefit of faster rehabilitation and return to work.

Clenched fist is a rare disorder of the hand associated with fixed contractures of fingers. The condition is often preceded by minor trauma or surgery, but these do not explain the severity of the contractures. Extension of the fingers is painful and hygienic problems can be considerable. Psychiatric disease is frequent in clenched fist patients. The patients may express a strong wish for amputations. In a review of eight patients with clenched fist who had claimed economic compensation from the Danish Patient Insurance Association, four patients had amputations. Three of them subsequently developed new contractures.