ENDOSCOPIC CARPAL-TUNNEL DECOMPRESSION

A study of endoscopic carpal tunnel release was carried out in three p arts, consisting of initial cadaveric dissections, a prospective pilot study of 20 patients and a prospective, randomized trial of 71 patien ts comparing endoscopic with open decompression. In the main trial, 25 patients with bilateral symptoms underwent simultaneous endoscopic an d open release, with the remainder randomized to one or other techniqu e. Both techniques effectively decompressed the median nerve. A signif icant improvement in grip and pinch strength over 3 months was achieve d in those undergoing endoscopic surgery. Average return to work was 1 4 days in the endoscopic series and 39 days in the open series. A comp lication rate of 35% was achieved with the transbursal endoscopic tech nique, 3.7% with the extrabursal endoscopic technique and 13.5% in the open series.