title: Endoscopically assisted nerve decompression of rare nerve compression syndromes at the upper extremity.
abstract: BACKGROUND
  Besides carpal tunnel and cubital tunnel syndrome, other nerve compression or constriction syndromes exist at the upper extremity. This study was performed to evaluate and summarize our initial experience with endoscopically assisted decompression.
  
  
  METHODS
  Between January 2011 and March 2012, six patients were endoscopically operated for rare compression or hour-glass-like constriction syndrome. This included eight decompressions: four proximal radial nerve decompressions, and two combined proximal median nerve and anterior interosseus nerve decompressions. Surgical technique and functional outcomes are presented.
  
  
  RESULTS
  There were no intraoperative complications in the series. Endoscopy allowed both identifying and removing all the compressive structures. In one case, the proximal radial neuropathy developed for 10 years without therapy and a massive hour-glass nerve constriction was observed intraoperatively which led us to perform a concurrent complementary tendon transfer to improve fingers and thumb extension. Excellent results were achieved according to the modified Roles and Maudsley classification in five out of six cases. All but one patient considered the results excellent. The poorest responder developed a CRPS II and refused post-operative physiotherapy.
  
  
  CONCLUSIONS
  Endoscopically assisted decompression in rare compression syndrome of the upper extremity is highly appreciated by patients and provides excellent functional results. This minimally invasive surgical technique will likely be further described in future clinical studies.
authors: Department of Plastic and Hand Surgery, Inselspital Bern, University of Bern, Bern, Switzerland. franckleclere@yahoo.fr
authors: Franck Marie P
authors: FM
authors: Leclère
authors: Dietmar
authors: D
authors: Bignion
authors: Torsten
authors: T
authors: Franz
authors: Lukas
authors: L
authors: Mathys
authors: Esther
authors: E
authors: Vögelin
mesh_terms: D000328:Adult; D000368:Aged; D019299:Decompression, Surgical; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000601:surgery; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods; D011826:Radial Nerve / Q000601:surgery; D012189:Retrospective Studies; D034941:Upper Extremity / Q000294:innervation / Q000601:surgery; D055815:Young Adult