ENDOSCOPIC CARPAL-TUNNEL RELEASE

Objective. To assess the efficacy and safety of a new technique for ca rpal tunnel release. Design: A single-group prospective cohort study. Setting. A referral-based hand-surgery university practice. Patients. Ninety-five consecutive adults; 1 patient was excluded (35 men, 59 wom en). They underwent 108 surgical procedures. No patients were lost to follow-up. Interventions: Endoscopic carpal tunnel release. Outpatient surgery with neuroleptic anesthesia. Two-portal Chow technique of rel ease. Main Outcome Measures. Symptom relief, return to work, medicatio n use and complication rate. Results. The average preoperative duratio n of symptoms was 3.9 years. Nerve conduction studies were positive in 101 of the 108 hands. Only two patients required open release. Only e ight patients complained of intraoperative pain. Six patients failed t o obtain relief of symptoms; two of them required secondary open relea se owing to persistent symptoms. Of the 61 patients who were employed, 52 returned to their previous jobs without restriction. The mean time for return to work was 36.4 days for patients who were Workers' Compe nsation Board cases and 19.5 days for patients who were not (p < 0.01) . Men returned to work in 17.7 days and women in 24.7 days (p < 0.05). Complications occurred in four patients (3.8%). No nerve injury, vasc ular injury or reflex sympathetic dystrophy was noted. Patients who ha d undergone previous contralateral open release noted less pain and ea rlier return to work after endoscopic carpal tunnel release. Conclusio ns. Endoscopic carpal tunnel release was effective in relieving sympto ms and had a low complication rate. The technique was associated with early return to work and minimal palmar pain.