Adequacy and long-term prognosis of endoscopic carpel tunnel release

Forty-one hands of 37 patients with idiopathic carpal tunnel syndrome treat ed by endoscopic carpal tunnel release (ECTR) were followed up for more tha n one year after surgery. Surgical results were evaluated using Kelly's cri teria, the Semmes-Weinstein test, the static and moving 2-point discriminat ion tests, tip-pinch strength, and motor and sensory nerve conduction studi es. Clinical results, according to Kelly's criteria three months after surg ery, were excellent or good in 36 hands, and fair or poor in five hands. No recovery was evident at six months and 12 months after surgery in fair and poor hands. Based on these findings, we conclude that a neurolysis of the median nerve and release of constriction of the thenar muscle branch should be performed using the conventional open technique for patients with poor results three months after ECTR if the patients are dissatisfied with ECTR results.