A multicenter prospective review of 640 endoscopic carpal tunnel releases using the transbursal and extrabursal chow techniques

Nagle, Daniel J.; Fischer, Thomas J.; Harris, Gerald D.; Hasting, Hill; Osterman, A. Lee; Palmer, Andrew K.; Viegas, Steven F.; Whipple, Terry L.; Foley, Marijoy

doi:10.1016/s0749-8063(96)90001-8

Cited by 49 publications

(23 citation statements)

References 10 publications

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“…Since ECTR is minimally invasive, it permits early return to normal activities and work. Similar to the present study in which the time to return to work for the patients ranged from 7 to 35 days (mean, 15 days), Nagle et al reported that 81% of the non-worker's compensation patients returned to work less than 4 weeks after the procedure 6 . Kerr et al found that patients treated endoscopically irrespective of insurance class, returned to work 10.6 days sooner than did those treated by open method 4 .…”

Section: Discussionsupporting

confidence: 83%

Endoscopic Carpal Tunnel Release – A Prospective Study of Functional Outcome

Thuraisingham¹,

Ahmad²,

Loh³

2009

MOJ

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To evaluate the functional outcome of patients who underwent endoscopic carpal tunnel release (ECTR). This was a prospective study in 24 patients with idiopathic carpal tunnel syndrome undergoing ECTR . Patient assessment entailing both subjective and objective tests at intervals of two and six weeks, three, six and nine months and finally at one year postoperatively. Our assessment results showed overall improvement in symptoms. As early as two weeks post-operatively, there was a low incidence of pillar pain and scar tenderness, allowing patients to return to work early. There were no serious complications. ECTR can be effectively performed with a low perioperative and late postoperative rate of complications. This minimally invasive method can be an option of surgical treatment for patients with carpal tunnel syndrome, who intend to return to work soon after surgery.

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Section: Discussionsupporting

confidence: 83%

Endoscopic Carpal Tunnel Release – A Prospective Study of Functional Outcome

Thuraisingham¹,

Ahmad²,

Loh³

2009

MOJ

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“…Along with the early clinical experience came numerous reports of major complications including median (13)(14)(15)(16), ulnar (17) and digital nerve (18) transections; superficial palmar arch injuries (2,3,19); and flexor tendon laceration (19). In spite of the concerning nature of these reports, such complications were reported soon after the introduction of ECTR and represented the early, and oftentimes preliminary, experience with this technique.…”

Section: Discussionmentioning

confidence: 99%

Early major complications of endoscopic carpal tunnel release: A review of 1200 cases

Tse¹,

Hurst²

2003

J Plast Surg

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RW Tse, LN Hurst, TA Al-Yafi. Early major complications of endoscopic carpal tunnel release: A review of 1200 cases. Can J Plast Surg 2003;11(3):131-134. Although the early benefits of endoscopic carpal tunnel release have been demonstrated, there is great controversy regarding the risks and safety of the technique. The present study reports early major complications in a series of 1278 consecutive cases performed by a single surgeon over a seven-year period. All procedures were performed under local anaesthesia on an outpatient basis using the Agee single portal technique. Mean follow-up was three months. No vascular, tendon or permanent nerve injuries were documented. Recurrent or persistent symptoms occurred in 7% of patients for which 20 of 89 underwent subsequent open carpal tunnel release. No nerve injuries were found on re-exploration. Other complications were consistent with previously reported incidences. This is the largest reported case series by a single surgeon and represents an accumulation of surgical experience at the upper end of the learning curve. Endoscopic carpal tunnel release is a safe procedure in this experienced single surgeon series. Complications majeures précoces de la libéra-tion endoscopique du nerf médian au niveau du canal carpien Bien que les bénéfices précoces de la libération endoscopique du nerf médian au niveau du canal carpien soient démontrés, il existe une grande controverse au sujet des risques et de l'innocuité de la technique. La présente étude fait état de complications majeures précoces dans une série de 1 278 cas consécutifs opérés par un seul chirurgien en l'espace de sept ans. Toutes les interventions ont été exécutées sous anesthésie locale en clinique externe au moyen de la technique portale unique d'Agee. Le suivi moyen était de trois mois. Aucune lésion vasculaire, tendineuse ou nerveuse permanente n'a été documentée. Des symptômes récurrents ou persistants se sont manifestés chez 7 % des patients, et 20 de ces 89 patients ont subi une libération ouverte du nerf médian au niveau du canal carpien. Aucune lésion nerveuse n'a été découverte au moment de la deuxième exploration. D'autres complications étaient compatibles avec des incidences déclarées auparavant. C'est la plus grande série de cas à être déclarée par un seul chirurgien, et elle représente une accumulation d'expérience clinique dans le haut de la courbe d'apprentissage. La libération endoscopique du nerf médian au niveau du canal carpien est une intervention sûre dans le cadre de cette série effectuée par un seul chirurgien expérimenté.

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“…Because open techniques are so straightforward and should have virtually no incidence of incomplete release of the TCL, and because complete release of the TCL is paramount to achieving the extraordinary success rates of all surgical treatments of CTS, it has been considered imperative that endoscopic techniques at least accomplish the same degree of complete TCL release. In large series with experienced surgeons, the rate of incompletely sectioning the TCL is <0.5%, which is virtually identical to open techniques, 24,115,155 but reports of training with cadavers imply that early stages of experience with these techniques can be troublesome. Lee et al 98 reported on the results of five newly trained surgeons using a two-portal technique.…”

Section: Median Nerve Entrapment At the Wristmentioning

confidence: 95%