Endoscopic treatment of carpal tunnel syndrome: a critical review

1998 ◽  
Vol 88 (5) ◽  
pp. 817-826 ◽  
Author(s):  
David F. Jimenez ◽  
Scott R. Gibbs ◽  
Adam T. Clapper
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Critical Review ◽  
Carpal Tunnel Release ◽  
Content Type ◽  
Endoscopic Techniques ◽  
Endoscopic Carpal Tunnel Release ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Release Surgery ◽  
Fine Print

Object. The goal of this paper is to present a critical review of the endoscopic procedures currently in use for the treatment of carpal tunnel syndrome. Endoscopic techniques and outcomes are discussed. Methods. 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. In many studies in which open and endoscopic techniques were compared, it was reported that patients in the the latter group experienced significantly less pain and returned to work and activities of daily living earlier. Conclusions. Success and complication rates of endoscopic carpal tunnel release surgery are similar to those for standard open procedures.

scholarly journals Endoscopic treatment of carpal tunnel syndrome: a critical review

1997 ◽  
Vol 3 (1) ◽  
pp. E8 ◽  
Author(s):  
David F. Jimenez ◽  
Scott R. Gibbs ◽  
Adam T. Clapper
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Complication Rates ◽  
Palmar Arch ◽  
Endoscopic Techniques ◽  
Endoscopic Carpal Tunnel Release ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Release Surgery ◽  
Mean Time

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.

INVESTIGATION OF SEGMENTAL CARPAL TUNNEL PRESSURE IN PATIENTS WITH IDIOPATHIC CARPAL TUNNEL SYNDROME — IS IT NECESSARY TO RELEASE THE DISTAL APONEUROTIC PORTION OF THE FLEXOR RETINACULUM IN ENDOSCOPIC CARPAL TUNNEL RELEASE SURGERY?

Hand Surgery ◽  
2007 ◽  
Vol 12 (03) ◽  
pp. 205-209 ◽  
Author(s):  
Keiichi Murata ◽  
Hiroshi Yajima ◽  
Naoki Maegawa ◽  
Koji Hattori ◽  
Yoshinori Takakura
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Guide Wire ◽  
Carpal Tunnel Release ◽  
Endoscopic Carpal Tunnel Release ◽  
Flexor Retinaculum ◽  
Before And After ◽  
Idiopathic Carpal Tunnel Syndrome ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Release Surgery

Segmental carpal tunnel pressure was measured in 12 hands of 11 idiopathic carpal tunnel syndrome patients before and after two-portal endoscopic carpal tunnel release. We aimed to determine at which part of the carpal tunnel the median nerve could be compressed, and to evaluate whether carpal tunnel pressure could be reduced sufficiently at all segments of the carpal tunnel after the surgery. Pressure measurements were performed using a pressure guide wire. The site with the highest pressure corresponded to the area around the hamate hook; the pressure in the area distal to the flexor retinaculum could be pathogenically high (more than 30 mmHg) before the surgery. The two-portal endoscopic carpal tunnel release achieved sufficient pressure reduction in all segments of the carpal tunnel when the flexor retinaculum and the fibrous structure between the flexor retinaculum and the palmar aponeurosis were completely released.

Transillumination in minimally invasive surgery for carpal tunnel release

1996 ◽  
Vol 85 (6) ◽  
pp. 1184-1186 ◽  
Author(s):  
Angelo Franzini ◽  
Giovanni Broggi ◽  
Domenico Servello ◽  
Ivano Dones ◽  
Maria Grazia Pluchino
Keyword(s):  
Minimally Invasive Surgery ◽  
Carpal Tunnel Syndrome ◽  
Minimally Invasive ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Alternative Technique ◽  
Content Type ◽  
Operative Results ◽  
Tunnel Syndrome ◽  
Fine Print

✓ An alternative technique for performing minimally invasive release of carpal tunnel syndrome is described. The suggested methodology is based on transillumination of the carpal tunnel during surgery. The advantages of the technique are discussed and compared with other available surgical procedures including endoscopy. The authors also describe preliminary operative results in 50 consecutive patients.

Endoscopic Carpal Tunnel Release

2019 ◽  
pp. 989-994
Author(s):  
Antony Hazel ◽  
Neil F. Jones
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Hand Surgery ◽  
Anatomical Landmarks ◽  
Transverse Carpal Ligament ◽  
Palmar Arch ◽  
Endoscopic Carpal Tunnel Release ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Release Surgery ◽  
Open Carpal Tunnel Release

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.

Surgery of the carpal tunnel

1978 ◽  
Vol 49 (2) ◽  
pp. 316-318 ◽  
Author(s):  
Noel Eboh ◽  
Donald H. Wilson
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Modified Technique ◽  
Content Type ◽  
Electrical Studies ◽  
Entrapment Neuropathies ◽  
Palmaris Longus ◽  
Tunnel Syndrome ◽  
Fine Print

✓ The authors describe a modified technique for surgery of the carpal tunnel. The primary cause of the carpal tunnel syndrome is the same as other entrapment neuropathies: an enlarged nerve within a tight tunnel. Electrical studies have shown that the area of compression is in the middle of the tunnel. Treatment is surgical: a palmar incision, which begins at the wrist medial to the palmaris longus, to avoid damage to the sensory branch of the median nerve; and section of the retinaculum from the exit of the tunnel toward the entrance.

Carpal Tunnel Syndrome Accompanying Radial Dysplasia Due to Thalidomide Embryopathy

2006 ◽  
Vol 31 (3) ◽  
pp. 342-344 ◽  
Author(s):  
Y. OSHIMA ◽  
I. OKUTSU ◽  
I. HAMANAKA ◽  
T. MOTOMURA
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Pressure Measurements ◽  
Endoscopic Carpal Tunnel Release ◽  
Sensory Disturbances ◽  
Tingling Sensation ◽  
Tunnel Syndrome

We performed endoscopic carpal tunnel release in four hands in three patients suffering from radial dysplasia due to thalidomide embryopathy. Carpal canal pressure measurements results confirmed the diagnoses. All operations were successfully performed and resulted in no complications. Tingling sensation and sensory disturbances of the hands subsided.

Patient-reported outcomes of carpal tunnel release surgery in patients with bilateral severe carpal tunnel syndrome

2017 ◽  
Vol 42 (9) ◽  
pp. 932-936 ◽  
Author(s):  
C. Q. Y. Tang ◽  
S. W. H. Lai ◽  
S. C. Tay
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Complete Resolution ◽  
Patient Reported Outcomes ◽  
Operative Time ◽  
Carpal Tunnel Release ◽  
Level Of Evidence ◽  
Patient Reported ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Release Surgery

This retrospective study examined whether the presenting complaint of numbness is relieved post-operatively in severe carpal tunnel syndrome and also assessed any correlation between outcomes of the first and second procedures in staged bilateral carpal tunnel releases. Carpal tunnel release (60 open and 38 endoscopic) was done in 49 patients with bilateral severe carpal tunnel syndrome. There was complete resolution of numbness post-operatively in 77% ( n = 75) of hands. The median post-operative time before complete resolution of numbness was 21 days (IQR 8 to 21; range 3 to 482). The likelihood of complete resolution of symptoms after the second carpal tunnel release in patients with complete resolution of symptoms after the first carpal tunnel release was 22 (95% CI: 4 to 131) times that of the likelihood of improvement in patients with incomplete resolution of symptoms after the first carpal tunnel release. Level of evidence: IV

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.

Carpal tunnel syndrome caused by thrombosis of the median artery: importance of high-resolution ultrasonography for diagnosis

2002 ◽  
Vol 97 (2) ◽  
pp. 471-473 ◽  
Author(s):  
Henrich Kele ◽  
Raphaela Verheggen ◽  
Carl Detlev Reimers
Keyword(s):  
High Resolution ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Rare Case ◽  
Content Type ◽  
The Third ◽  
Tunnel Syndrome ◽  
Median Artery ◽  
High Resolution Ultrasonography ◽  
Fine Print

✓ The rare case of a patient with carpal tunnel syndrome caused by thrombosis of a persistent median artery is presented. Progressive pain in the wrist and dysesthesias in the third and fourth fingers were the atypical complaints. High-resolution ultrasonography revealed a bifid median nerve that was compressed by an occluded median artery. The intraoperative findings are described, and emphasis is placed on the importance of using high-resolution ultrasonography for presurgical diagnosis.

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