Single-Portal Endoscopic Carpal Tunnel Release Compared with Open Release

2002 ◽  
Vol 84 (7) ◽  
pp. 1107-1115 ◽  
Author(s):  
Thomas E. Trumble ◽  
Edward Diao ◽  
Reid A. Abrams ◽  
Mary M. Gilbert-Anderson
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Open Release ◽  
Endoscopic Carpal Tunnel Release

ENDOSCOPIC CARPAL TUNNEL RELEASE FOR RECURRENT CARPAL TUNNEL SYNDROME AFTER PREVIOUS OPEN RELEASE

Hand Surgery ◽  
2004 ◽  
Vol 09 (02) ◽  
pp. 235-239 ◽  
Author(s):  
Lam Chuan Teoh ◽  
Puay Ling Tan
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Open Release ◽  
Endoscopic Carpal Tunnel Release ◽  
Endoscopic Release ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release ◽  
Surgical Release

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.

Morphologic Analysis of the Carpal Tunnel and Median Nerve Following Open and Endoscopic Carpal Tunnel Release

Hand ◽  
2019 ◽  
pp. 155894471986171 ◽  
Author(s):  
Blair R. Peters ◽  
Amanda M. Martin ◽  
Brett F. Memauri ◽  
Hardy W. Bock ◽  
Robert B. Turner ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Resonance Imaging ◽  
Open Release ◽  
Endoscopic Carpal Tunnel Release ◽  
Endoscopic Release ◽  
Significant Difference

Background: Endoscopic carpal tunnel release (ECTR) has purported advantages over open release such as reduced intraoperative dissection and trauma and more rapid recovery. Endoscopic carpal tunnel release has been shown to have comparable outcomes to open release, but open release is considered easier and safer to perform. Previous studies have demonstrated an increase in carpal tunnel volume, regardless of the technique used. However, the mechanism by which this volumetric increase occurs has been debated. Our study will determine through magnetic resonance imaging (MRI) analysis the morphologic changes that occur in both open carpal tunnel release (OCTR) and ECTR, thereby clarifying any morphologic differences that occur as a result of the 2 operative techniques. We hypothesize that there will be no morphologic differences between the 2 techniques. Methods: This was a prospective study to compare the postoperative anatomy of both techniques with MRI. Nineteen patients with clinical and nerve conduction study–confirmed carpal tunnel syndrome underwent either open or endoscopic release. Magnetic resonance imaging was performed preoperatively and 6 months postoperatively in all patients to examine the volume of the carpal tunnel, transverse distance, anteroposterior (AP) distance, divergence of tendons, and Guyon’s canal transverse and AP distance. Results: There was no significant difference in the postoperative morphology of the carpal tunnel and median nerve between OCTR and ECTR at 6-month follow-up on MRI. Conclusion: We conclude that there are no morphologic differences in OCTR and ECTR. It is an increase in the AP dimension that appears to be responsible for the increase in the volume of the carpal tunnel.

ENDOSCOPIC CARPAL TUNNEL RELEASE AND CONGENITAL ANOMALIES OF THE MEDIAN NERVE

Hand Surgery ◽  
2003 ◽  
Vol 08 (02) ◽  
pp. 265-270 ◽  
Author(s):  
Andrew V. Cavallo ◽  
Philip G. Slattery ◽  
Richard J. Barton
Keyword(s):  
Median Nerve ◽  
Nerve Injury ◽  
Carpal Tunnel ◽  
Congenital Anomalies ◽  
Carpal Tunnel Release ◽  
Effective Means ◽  
Open Release ◽  
Endoscopic Carpal Tunnel Release ◽  
Endoscopic Release

Endoscopic release has been shown to be a safe and effective means of carpal tunnel decompression. The surgeon needs to be aware of the variations in the anatomy of the median nerve in order to minimise the risk of nerve injury. In this series of 748 endoscopic carpal tunnel releases, six were found to have variations in the median nerve anatomy, in two patients conversion to open release was necessary.

scholarly journals Incidence of Nerve Repair Following Endoscopic Carpal Tunnel Release Is Higher Compared to Open Release in New York State

2018 ◽  
Vol 15 (2) ◽  
pp. 143-146 ◽  
Author(s):  
Samir K. Trehan ◽  
Stephen Lyman ◽  
Yile Ge ◽  
Huong T. Do ◽  
Aaron Daluiski
Keyword(s):  
New York ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Nerve Repair ◽  
New York State ◽  
Open Release ◽  
York State ◽  
Endoscopic Carpal Tunnel Release

Early Experience with Endoscopic Carpal Tunnel Release

1994 ◽  
Vol 19 (1) ◽  
pp. 18-21 ◽  
Author(s):  
C. P. KELLY ◽  
D. PULISETTI ◽  
A. M. JAMIESON
Keyword(s):  
Median Nerve ◽  
Nerve Injury ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Early Experience ◽  
Standard Protocol ◽  
Open Release ◽  
Endoscopic Carpal Tunnel Release ◽  
Satisfactory Outcome ◽  
Wrong Diagnosis

83 hands in 69 patients had endoscopic carpal tunnel release by the Chow method over a 14-month period. 78% of these had a satisfactory outcome with relief of symptoms and no complications. Poor results were explained by incomplete ligament division (five patients), wrong diagnosis (two hands), and post-operative nerve problems (five hands). Two patients after Colles’ fractures had unsatisfactory results. Serious complications included two median nerve lacerations. One of these was clearly a result of deviation from the standard protocol. The authors believe that the technique has advantages over open release but they are divided on whether the benefits outweigh the risk of nerve injury.

Endoscopic carpal tunnel release: A comparison of two techniques with open release

1993 ◽  
Vol 9 (5) ◽  
pp. 498-508 ◽  
Author(s):  
David H. Palmer ◽  
J. Craig Paulson ◽  
Christa L. Lane-Larsen ◽  
Virginia K. Peulen ◽  
Janet D. Olson
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Open Release ◽  
Endoscopic Carpal Tunnel Release

Experiences with Endoscopic Carpal Tunnel Release

Swiss Surgery ◽  
2002 ◽  
Vol 8 (4) ◽  
pp. 181-185
Author(s):  
Buchli ◽  
Scharplatz
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Endoscopic Carpal Tunnel Release ◽  
Endoskopische Karpaltunnelspaltung

Im Spital Thusis wurden zwischen 1994 und 2000 122 Patienten wegen eines Karpaltunnelsyndroms operiert. Wir wollten wissen, ob die endoskopische Karpaltunnelspaltung in einem Regionalspital mit genügend hoher Sicherheit angewandt wurde und ob die Ergebnisse mit der offenen Karpaltunnelspaltung vergleichbar sind. In einer retrospektiven Studie konnten wir 82 Patienten mittels Fragebogen über das Operationsergebnis befragen. 39 Patienten wurden offen operiert, 26 mittels der Zweipfortentechnik nach Chow und 17 mittels Einpfortentechnik nach Agee. Schwere irreversible Komplikationen wurden nicht beobachtet. Bezüglich der Operationsergebnisse zeigten sich keine signifikanten Unterschiede in den drei Gruppen. Von den 39 offenen Karpaltunnelspaltungen klagten neun Patienten über Restbeschwerden, wobei es zu einer Reoperation wegen einer Thenarastverletzung kam. Bei den 26 endoskopischen Karpaltunnelspaltungen in Zweipfortentechnik traten bei acht Patienten Restbeschwerden auf, wobei eine Reoperation wegen exzessiver Vernarbung durchgeführt werden musste. Bei den 17 Operationen nach Agee hatten fünf Patienten Restbeschwerden, es musste jedoch keiner reoperiert werden. Die Studie zeigt, dass mit den drei unterschiedlichen Operationsverfahren bezüglich Sicherheit und Therapieerfolg vergleichbare Resultate erreicht wurden. Vorteile wegen dem atraumatischeren Zugang der endoskopischen Techniken konnten wir jedoch nicht objektivieren.

WALANT Technique versus Sedation for Endoscopic Carpal Tunnel Release

Hand ◽  
2021 ◽  
pp. 155894472110031
Author(s):  
Ian Wellington ◽  
Antonio Cusano ◽  
Joel V. Ferreira ◽  
Anthony Parrino
Keyword(s):  
Local Anesthesia ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Postanesthesia Care Unit ◽  
Complication Rates ◽  
Endoscopic Carpal Tunnel Release ◽  
Average Operating ◽  
Wide Awake ◽  
No Tourniquet ◽  
Room Time

Background This study sought to investigate complication rates/perioperative metrics after endoscopic carpal tunnel release (eCTR) via wide-awake, local anesthesia, no tourniquet (WALANT) versus sedation or local anesthesia with a tourniquet. Methods Patients aged 18 years or older who underwent an eCTR between April 28, 2018, and December 31, 2019, by 1 of 2 fellowship-trained surgeons at our single institution were retrospectively reviewed. Patients were divided into 3 groups: monitored anesthesia care with tourniquet (MT), local anesthesia with tourniquet (LT), and WALANT. Results Inclusion criteria were met by 156 cases; 53 (34%) were performed under MT, 25 (16%) under LT, and 78 (50%) under WALANT. The MT group (46.1 ± 9.7) was statistically younger compared with LT (56.3 ± 14.1, P = .007) and WALANT groups (53.5 ± 15.8, P = .008), F(2, 153) = 6.465, P = .002. Wide-awake, local anesthesia, no tourniquet had decreased procedural times (10 minutes, SD: 2) compared with MT (11 minutes, SD: 2) and LT (11 minutes, SD: 2), F(2, 153) = 5.732, P = .004). Trends favored WALANT over MT and LT for average operating room time (20 minutes, SD: 3 vs 32 minutes, SD: 6 vs 23 minutes, SD: 3, respectively, F(2, 153) = 101.1, P < .001), postanesthesia care unit time (12 minutes, SD: 7 vs 1:12 minutes, SD: 26 vs 20 minutes, SD: 22, respectively, F(2, 153) =171.1, P < .001), and door-to-door time (1:37 minutes, SD: 21 vs 2:51 minutes, SD: 40 vs 1:46 minutes, SD: 33, respectively, F(2, 153) = 109.3, P < .001). There were no differences in complication rates. Conclusions Our data suggest favorable trends for patients undergoing eCTR via WALANT versus MT versus LT.

Systematic review and meta-analysis of surgical options for recurrent or persistent carpal tunnel syndrome: simple decompression versus coverage of the median nerve

2021 ◽  
pp. 175319342110017
Author(s):  
Saskia F. de Roo ◽  
Philippe N. Sprangers ◽  
Erik T. Walbeehm ◽  
Brigitte van der Heijden
Keyword(s):  
Systematic Review ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Meta Analysis ◽  
Surgical Techniques ◽  
Open Release ◽  
Flap Coverage ◽  
Tunnel Syndrome

We performed a systematic review on the success of different surgical techniques for the management of recurrent and persistent carpal tunnel syndrome. Twenty studies met the inclusion criteria and were grouped by the type of revision carpal tunnel release, which were simple open release, open release with flap coverage or open release with implant coverage. Meta-analysis showed no difference, and pooled success proportions were 0.89, 0.89 and 0.85 for simple open carpal tunnel release, additional flap coverage and implant groups, respectively. No added value for coverage of the nerve was seen. Our review indicates that simple carpal tunnel release without additional coverage of the median nerve seems preferable as it is less invasive and without additional donor site morbidity. We found that the included studies were of low quality with moderate risk of bias and did not differentiate between persistent and recurrent carpal tunnel syndrome.

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