A CADAVERIC STUDY OF THE SINGLE-PORTAL ENDOSCOPIC CARPAL-TUNNEL RELEASE

Forty-three human cadavers underwent single-portal endoscopic carpal t unnel release using the Agee technique. Subsequent independent open di ssection revealed complete release of all potentially compressing tran sverse structures in 19 specimens and incomplete release in 24 specime ns. There were 2 specimens with vascular injuries; one transection of a perforating branch of the palmar arch, and one transection of the ul nar artery at the entry portal. The 43 specimens were divided into thr ee groups: group 1 (13 specimens) were released by the senior author i n 1989; group 2 (13 specimens) were released by the senior author in 1 992; and group 3 (17 specimens) were released by surgeons learning the technique under direct supervision of the senior author. Complete rel ease was 5 of 13 for group 1, 6 of 13 for group 2, and 8 of 17 for gro up 3. This study indicates that incomplete release is an inherent feat ure of this technique regardless of the surgeon's experience and despi te blade redesign. The significance of incomplete release is unknown a nd must be determined in long-term clinical studies.