Comparison of proximal and distal one portal entry techniques for endoscopic carpal tunnel release. A cadaver study.
Reported complications of endoscopic carpal tunnel release have increased as more surgeons use this technique to release the flexor retinaculum. We used a cadaver model to compare the results of endoscopic carpal tunnel release through a one-portal distal (Group A, 15 specimens) and a one-portal proximal (Group B, 15 specimens) entry site with a new endoscopic technique. Our custom-made glass tube of three different sizes (5, 7, and 9 mm in diameter) is designed to house an endoscope and accommodate a meniscus knife for releasing the flexor retinaculum. Complete release of the flexor retinaculum was obtained in all limbs in both groups. In Group A the one complication (7%) was loss of the cotton tip from the cotton swab stick within the carpal tunnel. In Group B, there was a single case of injury to the superficial palmar arch in one hand and breakage of a glass tube in another hand, for a total complication rate of 13%. No other damage to anatomical structures was noted.
Tsuruta
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Christine M. Kleinert Institute for Hand and Micro Surgery, Louisville, Kentucky.
Syed
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Tsai
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D002102:Cadaver; D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods; D004867:Equipment Design; D006801:Humans; D011183:Postoperative Complications; D013514:Surgical Procedures, Operative / Q000379:methods; D016896:Treatment Outcome