CARPAL-TUNNEL RELEASE WITH AND WITHOUT EPINEUROTOMY - A COMPARATIVE PROSPECTIVE TRIAL

A prospective, comparative study of epineurotomy as an adjunctive proc edure to transverse carpal ligament release for the treatment of carpa l tunnel syndrome was conducted. Eighty-six patients with 117 involved hands were entered into the. study. After entry, all patients complet ed an extensive preoperative questionnaire, a detailed physical examin ation, and preoperative neurophysiologic testing. Seventy-five hands w ere followed for a minimum of 24 months. The operative findings were s imilar between the group of those undergoing epineurotomy and the grou p that did not undergo epineurotomy. Postoperatively the two-point dis crimination values for all fingers averaged 5.3 mm and 5.15 mm, respec tively, for the epineurotomy and nonepineurotomy groups. The physical findings, neurophysiologic findings, and patient perceptions of outcom e after surgery were similar. It was concluded that the study data do not support the use of epineurotomy as an adjunctive procedure during carpal tunnel release.