THE RESULTS OF REVISION CARPAL-TUNNEL RELEASE FOLLOWING PREVIOUS OPENVERSUS ENDOSCOPIC SURGERY

This study compared the outcomes of revision open carpal tunnel releas e following previous open versus endoscopic release to determine wheth er revision surgery has different results based on the type of initial surgical treatment. Thirty revision carpal tunnel releases were perfo rmed in 13 wrists that had previous endoscopic release and in 17 wrist s with prior open release. At a follow-up visit an average of 30 month s after surgery, self-assessment questionnaires demonstrated improved or complete symptom relief in 77% of the postendoscopic release group versus 47% in the previous open release group. Combining both groups, 18% of workers' compensation patients improved after revision surgery compared with 84% of those with conventional insurance (p <.05). Patie nts having persistent or recurrent symptoms following a previous endos copic carpal tunnel release have a greater chance of symptom improveme nt or resolution compared with patients who had previous open carpal t unnel surgery. Our results support the observation that a higher incid ence of incomplete release of the carpal tunnel is found with endoscop ic surgery than with open release. Copyright (C) 1998 by the American Society for Surgery of the Hand.