Note: To access the supplementary table accompanying this report, visit the September issue of Arthroscopy at www.arthroscopyjournal.org.
Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original articleComplications of Endoscopic and Open Carpal Tunnel Release
Section snippets
Methods
A Medline search was performed of literature from 1966 through 2001 to evaluate the complications of OCTR and ECTR. An attempt was made to identify all articles pertinent to carpal tunnel surgery. Keywords for the search included carpal tunnel, open carpal tunnel, endoscopic carpal tunnel, and complications. The articles selected for inclusion in this study were those that delineated complications of surgery for a series of patients who had undergone carpal tunnel release by any means. Only
Results
Of 68 articles that met inclusion criteria, 36 reported on 22,327 ECTR cases and 32 reported on 5,669 OCTR cases. Total numbers and types of complications for each surgical procedure are listed in Table 2. Transient neurapraxias are reported in 1.45% of ECTR cases and in 0.25% of OCTR cases. Major nerve injuries are reported in 0.13% of ECTR cases and in 0.10% of OCTR cases; digital nerve injuries are reported in only 0.03% of ECTR cases and in 0.39% of OCTR cases. Tendon injuries are noted in
Discussion
This study shows that the endoscopic approach to carpal tunnel release is not more likely to produce structural injury to tendon, arteries, or nerves than the open approach. From a clinical relevance standpoint, many reasons may be suggested for why some surgeons prefer an open approach over an endoscopic approach, but these data would reveal that safety for the endoscopic approach is comparable to that for the open method. Indeed, damage to median or ulnar nerves was not statistically
Conclusions
On the basis of studies published since 1966 on the open technique and studies published since 1989 on the endoscopic method, the percentages of structural complications to nerves, arteries, or tendons are 0.49% for the open approach and 0.19% for the endoscopic approach (via a transbursal or extrabursal method). The incidence of injury to the median or ulnar nerve with the open endoscopic approach is not statistically significantly different and corresponds to an incidence of approximately 1
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The authors report no conflict of interest.