Carpal Tunnel Syndrome: A Review of Endoscopic Release of the Transverse Carpal Ligament Compared With Open Carpal Tunnel Release

2001 ◽  
Vol 11 (1) ◽  
pp. 17-25 ◽  
Author(s):  
Claudia Janz ◽  
Stefanie Hammersen ◽  
Mario Brock
Hand Surgery ◽  
2004 ◽  
Vol 09 (02) ◽  
pp. 235-239 ◽  
Author(s):  
Lam Chuan Teoh ◽  
Puay Ling Tan

Recurrent carpal tunnel syndrome from various causes has been shown to occur in up to 19% of patients. Endoscopic carpal tunnel release has been used to decompress the median nerve in carpal tunnel syndrome for many years. However, endoscopic release for recurrent carpal tunnel syndrome after previous surgical release has not been reported. Nine hands in six patients had recurrent carpal tunnel syndrome five to 20 years after previous open carpal tunnel release. All the cases were successfully treated with endoscopic release.


Hand Surgery ◽  
2003 ◽  
Vol 08 (01) ◽  
pp. 59-63 ◽  
Author(s):  
Michael P. Bradley ◽  
Edward P. Hayes ◽  
Arnold-Peter C. Weiss ◽  
Edward Akelman

Mini-open carpal tunnel release has been the focus of recent attention for surgical decompression of carpal tunnel syndrome. Other techniques such as standard open carpal tunnel release and endoscopic release have been well established, and outcomes, complications and results for these operations have been published widely. Our study uses the validated Levine Katz questionnaire for carpal tunnel syndrome to measure patient subjective outcomes at one year follow-up after mini-open carpal tunnel release. Thirty-four consecutive hands were enrolled prospectively with preoperative and postoperative questionnaires. Mean symptom severity scores per question improved from 2.8 to 1.3 and mean function severity scores per question improved from 2.6 to 1.3. Comparing our data to the historical cohort of Levine et al., there was a statistically significant improvement in postoperative outcomes in our population (p < 0.0001).


2019 ◽  
Vol 2 (1) ◽  
pp. 8-14
Author(s):  
Sagun Pradhan ◽  
Rishi Bista ◽  
Laxman Sharma ◽  
Nabin Poudel ◽  
Bhawana Amatya

Introduction: Carpal tunnel syndrome is the most common compression neuropathy in clinical practice and is also the most extensively studied. In Mini-open carpal tunnel release, the transverse carpal ligament is transected using a small open cut at the volar aspect of the proximal palm. The objectives of this study were to determine the functional outcome of mini-open carpal tunnel release procedure, to use the Boston Questionnaire to determine the functional outcome following mini open carpal tunnel release which includes pain, numbness, weakness and fine hand activities. Methods: This descriptive cross-sectional was conducted in National After informed consent, the cases who meet the informed criteria were examined and relevant details were filled up in the proforma preoperatively and two weeks post-operatively. Assessment of the patient’s symptom severity and functional status was done with the Boston questionnaire. Results: CTS was most common in the age group of 25-29 years (36.36%) and was predominant in housewives (18.20%). Mean symptom severity scores per person improved from 3.11 pre-operatively to 1.12 post-operatively. Mean functional status scores per person improved from 2.65 pre-operatively to 1.03 post-operatively. There was a statistically significant improvement in postoperative outcomes in our population. Conclusions: The findings in this study indicate that mini-open carpal tunnel release has a good functional outcome. Keywords: carpal tunnel syndrome; compression neuropathy; transverse carpal ligament.


2019 ◽  
pp. 989-994
Author(s):  
Antony Hazel ◽  
Neil F. Jones

Conventional open carpal tunnel release surgery is one of most successful procedures in hand surgery and has been demonstrated to be an effective treatment for carpal tunnel syndrome. However, a known sequelae in some individuals who undergo the procedure is “pillar” pain. In an effort to avoid this condition and help people return to work more quickly, the endoscopic technique was developed. Endoscopic carpal tunnel release offers a minimally invasive alternative to other traditional techniques with similar outcomes. By placing the incision proximal to the transverse carpal ligament there is potential for decreased scar sensitivity and pillar pain. The technique is technically demanding. The superficial palmar arch and common digital nerve to the ring and middle fingers are at risk for injury during the procedure. With adherence to anatomical landmarks and the proper visualization, the surgery may be safely performed.


Author(s):  
Suk H. Yu ◽  
Tracy A. Mondello ◽  
Zong-Ming Li

Carpal tunnel syndrome is conventionally treated by open and endoscopic release surgeries in which transecting the transverse carpal ligament (TCL) relieves mechanical insults around the median nerve. The TCL release surgeries yield an increase in the tunnel cross-sectional area particularly within the volar aspect of the tunnel, the arch area, where the median nerve is located. As a result of increased arch area, post-operative follow-up studies using MRI confirmed a significant volar migration of the median nerve [1]. However, transecting the TCL compromises critical biomechanical roles of the carpal tunnel [2], and therefore, it is imperative to investigate an alternative method for treating carpal tunnel syndrome patients while preserving the TCL. Li et al. suggested that increasing the TCL length and narrowing the carpal arch width (CAW) as potential alternatives for increasing the arch area [3]. However, the data from their application of palmarly directed forces to the TCL from inside of the tunnel showed that the TCL length remained relatively constant while the carpal bones were mobilized to increase the arch area [3]. The purpose of this study was to investigate the relationship between CAW narrowing and the TCL-formed arch area by experimental and geometrical modeling.


2006 ◽  
Vol 31 (6) ◽  
pp. 608-610 ◽  
Author(s):  
M. M AL-QATTAN

During open carpal tunnel release in patients with severe idiopathic carpal tunnel syndrome, an area of constriction in the substance of the median nerve is frequently noted. In a prospective study of 30 patients, the central point of the constricted part of the nerve was determined intraoperatively and found to be, on average, 2.5 (range 2.2–2.8) cm from the distal wrist crease. This point always corresponded to the location of the hook of the hamate bone. These intraoperative findings were compared with the “narrowest” point of the carpal canal as determined by anatomical and radiological studies in the literature.


Hand Surgery ◽  
2002 ◽  
Vol 07 (02) ◽  
pp. 299-303 ◽  
Author(s):  
Kenji Yamauchi

Herein is described a haemodialysis patient with bilateral carpal tunnel syndrome suffering from recurrence unilaterally after undergoing numerous surgeries of varying methods. On the left side, she received carpal tunnel release via open method in our clinic, and has not suffered from recurrence in eight years. On the right side, she received endoscopic carpal tunnel release twice in seven years, and subsequently underwent open carpal tunnel release in our clinic for recurrence. For carpal tunnel syndrome in haemodialysis patients, we recommend open surgery rather than endoscopic surgery.


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