ENDOSCOPIC CARPAL-TUNNEL RELEASE USING A SINGLE-PORTAL SYSTEM

In this prospective clinical study, we present our experience with a n ew single portal carpal tunnel release kit. The safety and efficacy of this new device was assessed and compared with a consecutive control group treated with conventional open carpal tunnel release. 126 patien ts were enrolled in this study, 64 of them were treated endoscopically (group 1) and 62 by open release of the carpal ligament (group 2). Fo llow-ups were conducted at 1, 3, 6, 12 and 24 weeks postoperatively. A serious intraoperative complication in group I was a transection inju ry of a branch of the superficial palmar arch. No intraoperative compl ications were noted in group 2. Postoperative evaluation revealed sign ificantly less scar tenderness in group 1 at 1 week (P < 0.001), 3 wee ks (P < 0.001) and 24 weeks (P < 0.05) compared to group 2. Functional status at 1 week was significantly (P < 0.05) better in group 1 than in group 2 but not at later times. Grip strength at I week (P < 0.001) , 3 weeks (P < 0.05) and 12 weeks (P < 0.05), and pinch strength at 3 weeks (P < 0.001) were significantly higher in group 1. No significant differences between the groups were obtained regarding postoperative symptom severity. The new device provides a reliable tool for single p ortal carpal tunnel release, although the risk of inadvertent damage t o the neurovascular structures always remains a possibility with the e ndoscopic carpal tunnel technique.