SINGLE-PORTAL ENDOSCOPIC CARPAL-TUNNEL RELEASE - AGEE CARPAL-TUNNEL RELEASE SYSTEM

This single-group prospective cohort study was conducted to define the efficacy and safety of single-portal endoscopic carpal tunnel release using the redesigned carpal tunnel release system (3M Healthcare, St Paul, MN). Eighty-six procedures in 69 patients were evaluated by obje ctive motor/sensory testing and clinical outcome questionnaire at 10 d ays, and 6 and 10 weeks postoperatively. All cases were performed by t he same surgeon using a similar local anesthetic technique. The subjec tive symptoms of carpal tunnel syndrome, including paresthesia, numbne ss, and pain, demonstrated substantial improvement by 10 days postoper atively, and less than 2% of the subjects remained symptomatic by 10 w eeks. The percentage of patients with normal, static, two-point discri mination in the median nerve distribution, demonstrated significant im provement by 6 weeks postoperatively. Preoperative grip and three-poin t pinch strength were regained by 6 weeks postoperatively, while later al pinch demonstrated substantial improvement in the same time period. Workers' compensation cases required a significantly longer time to r eturn to work (mean, 40.8 days) than nonworkers' compensation cases (m ean, 22.2 days). No difference, however, was demonstrated between work ers' compensation and nonworkers' compensation cases with respect to t he time of return to activities of daily living(mean, 13.5 days). ther e were no major neurovascular injuries incurred during the performance of the study. The most important complications included one mild refl ex sympathetic dystrophy, three transient digital neuropraxias, and on e superficial wound infection. In conclusion, the performance of singl e-portal endoscopic carpal tunnel release using the redesigned Agee ca rpal tunnel release system is both a safe and efficacious procedure.