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Comparing Endocscopic and Open Release for Carpal Tunnel Syndrome

In this review, surgeons from the Illinois Bone and Joint Institute compare treatment results of carpal tunnel syndrome. Two two different surgical methods were used.

In both operations, a band of tissue across the wrist called the transverse carpal ligament is cut and released. The goal is to take pressure off the median nerve as it goes under the ligament and through a group of wrist bones called the carpal tunnel.

The first operation open carpal tunnel release (OCTS) is done with an incision over the carpal tunnel area. In the second procedure, the same ligament is released endoscopically. This operation is called an endoscopic carpal tunnel release (ECTR). A special tool is used to slip under the skin and release the ligament without an open incision.

All information on the results of these two methods was gathered from 68 articles published between 1966 and 2001. Researchers looked for any mention of complications with either operation. Problems such as nerve, tendon, or artery injuries were included.

Analysis showed no difference in the number of complications between the ECTR and the OCTR approaches. There wasn't enough evidence to support using the ECTR over the OCTR.

Surgeons use the ECTR because patients have less pain and a faster recovery. Those who continue to use the standard OCTR do so to avoid the possible serious complications of ECTR.

This review makes it clear that the number of complications with carpal tunnel release is low with either method of release. The choice between ECTR and OCTR may be a personal preference between the patient and surgeon.


Leon S. Benson, MD, et al. Complications of Endoscopic and Open Carpal Tunnel Release. In Journal of Arthroscopic and Related Surgery. September 2006. Vol. 22. No. 9. Pp. 919-924.

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