title: Retrospective analysis of 242 patients whose carpal tunnels were released using a one-port endoscopic procedure: superior results of early intervention.
abstract: Various approaches to endoscopic carpal tunnel release have been described, including the advantages of the open compared with the endoscopic technique. However recent results suggest that both are equal in terms of outcome and morbidity. The misconception about the potential morbidity and the hope of successful conservative treatment can sometimes delay operative release of the carpal tunnel. The aim of this study was to evaluate whether the preoperative duration of symptoms influences outcome and recovery. Patients who had endoscopic release of the carpal tunnel using a modified one-port method were included in this retrospective study. Patients' satisfaction and general outcome were analysed with a questionnaire. A total of 242 patients were included in the study, and the data of 170 endoscopic decompression operations were analysed (70%). There were no major operative complications, except the conversion to open release in one case. There was a significant association between the preoperative interval of symptoms and the return to everyday activities and normal function (p < 0.001). Patients with longer-lasting symptoms also had reduced recovery of postoperative strength, which was negatively associated with the duration of preoperative symptoms (p < 0.001). Operative decompression by the endoscopic one-port method is a low risk procedure with a low morbidity. The decision for operative decompression should be made as early as possible to avoid complications seen in patients with long-lasting symptoms and permanent nerve damage.
authors: Department of Plastic and Hand Surgery, University of Freiburg Medical Centre, Hugstetter Strasse 55, Freiburg, Germany. steffen.eisenhardt@uniklinik-freiburg.de
authors: Steffen U
authors: SU
authors: Eisenhardt
authors: Christian
authors: C
authors: Mathonia
authors: G Björn
authors: GB
authors: Stark
authors: Raymund E
authors: RE
authors: Horch
authors: Holger
authors: H
authors: Bannasch
mesh_terms: D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis* / Q000601:surgery*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D019299:Decompression, Surgical / Q000379:methods*; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D015999:Multivariate Analysis; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome