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J Wrist Surg 2021; 10(01): 064-069
DOI: 10.1055/s-0040-1715089
Procedure

Initial Outcomes of a Novel High-Visibility Endoscopic Carpal Tunnel Release Technique

Bo Liu 
1   Department of Hand Surgery, Beijing Ji Shui Tan Hospital, Fourth Clinical College of Peking University, Beijing, China
,
Feiran Wu
2   Department of Orthopaedics, University Hospitals Birmingham, Birmingham, United Kingdom
› Author Affiliations Funding The study was funded by the Beijing Municipal Administration of Hospitals Incubating Program (PX2018018) and Beijing Ji Shui Tan Hospital High-level Talents “Key Researcher” Program (XKGG201801).
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Abstract

Background A large variety of endoscopic carpal tunnel release methods have been described in efforts to shorten recovery time, reduce scar discomfort, and allow earlier return to work. The majority of existing techniques are the modifications of the Agee, Chow, and Menon techniques, all of which require dedicated equipment that can increase facility and surgical fees for the patient and institution. We present a novel high-visibility endoscopic carpal tunnel release technique that uses common hand surgery instruments available in all surgical units, without requiring disposable or custom devices.

Description of Technique The cases were performed under local anesthesia using routine reusable instruments and a conventional 2.5-mm 30-degree small joint arthroscope. Following proximal dissection, a clear, colorless, plastic shield was created from a standard syringe that offered a 360-degree vision of the carpal tunnel and protection of the median nerve. Release of the transverse carpal ligament was performed under full arthroscopic vision using Metzenbaum dissection scissors.

Methods This pilot study analyses the first nine cases in eight patients who were operated on using this technique, with a minimum of 6 months of follow-up.

Results No peri- or postoperative complications were encountered. All patients demonstrated significant improvements in the Disabilities of the Arm, Shoulder, and Hand score, the Boston Carpal Tunnel Questionnaire score, and a visual analog score for pain.

Conclusion The high-visibility endoscopic carpal tunnel release technique is safe and effective, and offers a viable cost-reducing alternative to the existing endoscopic methods for carpal tunnel syndrome. Future comparative trials are required to validate these findings in a larger series.

Level of Evidence This is a Level IV study.

Keywords

carpal tunnel - endoscopic carpal tunnel release - median nerve - nerve compression - peripheral neuropathy - cost reduction

Ethical Approval

The Local Ethical Committee approved the research protocol in advance.




Publication History

Received: 16 May 2020

Accepted: 17 June 2020

Article published online:
02 September 2020

© 2020. Thieme. All rights reserved.

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