Endoscopic treatment of carpal tunnel syndrome: a critical review.
OBJECTIVE
The goal of this paper is to present a critical review of the endoscopic procedures currently in use for the treatment of carpal tunnel syndrome. Endoscopic techniques and outcomes are discussed.


METHODS
An extensive review of published articles on the subject of endoscopic carpal tunnel release surgery is presented, encompassing six endoscopic techniques used to treat carpal tunnel syndrome. Since the first report in 1987, 7091 patients have undergone 8068 operations. The overall success rate has been 96.52%, with a complication rate of 2.67% and a failure rate of 2.61%. The mean time to return to work in patients not receiving Workers' Compensation was 17.8 days, ranging between 10.8 and 22.3 days. The most common complications were transient paresthesias of the ulnar and median nerves. Other complications included superficial palmar arch injuries, reflex sympathetic dystrophy, flexor tendon lacerations, and incomplete transverse carpal ligament division. In many studies in which open and endoscopic techniques were compared, it was reported that patients in the the latter group experienced significantly less pain and returned to work and activities of daily living earlier.


CONCLUSIONS
Success and complication rates of endoscopic carpal tunnel release surgery are similar to those for standard open procedures.
Jimenez
D F
DF
Division of Neurosurgery, University of Missouri Hospital and Clinics, Columbia, USA. djimenez@surgery.missouri.edu
Gibbs
S R
SR
Clapper
A T
AT
D000041:Absenteeism; D000203:Activities of Daily Living; D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D004651:Employment; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods; D006230:Hand Injuries / Q000209:etiology; D006801:Humans; D007431:Intraoperative Complications; D008023:Ligaments, Articular / Q000601:surgery; D008475:Median Nerve / Q000293:injuries / Q000503:physiopathology; D010149:Postoperative Pain / Q000517:prevention & control; D010292:Paresthesia / Q000209:etiology; D012019:Reflex Sympathetic Dystrophy / Q000209:etiology; D013708:Tendon Injuries / Q000209:etiology; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome; D014459:Ulnar Nerve / Q000293:injuries / Q000503:physiopathology; D014942:Workers' Compensation