Endoscopic treatment of carpal tunnel syndrome: a critical review

Abstract

<jats:p>An extensive review of published articles on the subject of endoscopic carpal tunnel release surgery is presented, encompassing six endoscopic techniques used to treat carpal tunnel syndrome. Since the first report in 1987, 7091 patients have undergone 8068 operations. The overall success rate has been 96.52%, with a complication rate of 2.67% and a failure rate of 2.61%. The mean time to return to work in patients not receiving Workers' Compensation was 17.8 days, ranging between 10.8 and 22.3 days. The most common complications were transient paresthesias of the ulnar and median nerves. Other complications included superficial palmar arch injuries, reflex sympathetic dystrophy, flexor tendon lacerations, and incomplete transverse carpal ligament division. All studies in which open and endoscopic techniques were compared reported that patients in the latter group experienced significantly less pain and returned to work and activities of daily living earlier. The reported success and complication rates of endoscopic carpal tunnel release surgery are similar to those for standard open procedures. Endoscopic techniques and outcomes are discussed.</jats:p>

Colour difference of subcutaneous fat and palmar fat pad in open carpal tunnel release

“…In a comprehensive review of carpal tunnel anatomy by Skandalakis et al ., reference is made to the specialized palmar fat related to the superficial arterial palmar arch in an area called the ‘distal zone’ . This has since been verified by radiological, endoscopic and surgical studies. None of these, however, mention the colour of the palmar fat in relation to the surrounding subcutaneous fat.…”

Carpel ligament release for carpel tunnel syndrome (CTS) under local anesthesia: our experience with 277 cases

“…3,16 Despite these advantages, complications such as incomplete release of ligament, vessels and nerve injuries and neuropraxiado occur .In addition to these recurrent hematoma and infection can occur as well. 7,10,22 Analysis of literature about OCTR entails a success rate of greater than 95% with a complication rate of less than 3% although recent study suggest similar complication when comparing OCTR and ECTR. 10,22 Despite no difference in the overall outcome of the disease when performing both the procedure,ECTR requires a steep learning curve as a surgeon needs effective hand-on course and cadaveric maneuvers which is technically demanding and requires more equipment when compared to OCTR.…”

Minimally invasive ultrasound‐guided carpal tunnel release: A cadaver study

“…The common goal of all three approaches is the division of the flexor retinaculum (FR), resulting in median nerve decompression. [1][2][3][4][5][6] The O-CTR is the most common approach. It is considered the gold standard for CTR with excellent clinical results and wide scientific acceptance.…”