Endoscopic Carpal Tunnel Release

Endoscopic Carpal Tunnel Release

Techniques, Controversies, and Comparison to Open Techniques

Jacques H. Hacquebord, MD; Jeffrey S. Chen, MD; Michael E. Rettig, MD

Disclosures

J Am Acad Orthop Surg. 2022;30(7):292-301. 

In This Article

Abstract and Introduction

Abstract

Endoscopic carpal tunnel release (ECTR) continues to rise in popularity as a treatment option for carpal tunnel syndrome. Numerous variations in technique and instrumentation currently exist, broadly classified into two-portal and single-portal techniques with antegrade and retrograde designs. ECTR is equally effective as open carpal tunnel release for alleviating symptoms of carpal tunnel syndrome with no differences in long-term outcomes. ECTR has an increased risk of transient nerve injury, whereas open carpal tunnel release has an increased risk of wound and scar complications. ECTR has higher direct costs but is associated with earlier return to work. ECTR is a safe and effective approach to carpal tunnel release in the hands of experienced surgeons.

Introduction

Carpal tunnel syndrome is the most common compressive peripheral neuropathy within the United States with an incidence of 1 to 3 cases per 1,000 patients per year and a prevalence as high as 5% in the general population.[1,2] Its diagnosis carries significant disability and economic burden with approximately 500,000 carpal tunnel releases performed annually and economic cost estimates in excess of $2 billion per year within the United States alone.[3]Timely surgical intervention after failure of conservative measures may reduce economic loss and prevent permanent disability and need for reconstructive procedures.

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