Question:Twenty years ago I had a carpal tunnel release done on my left wrist. There is still a long incision over my wrist but I'm perfectly fine now. My daughter had the same surgery but without an open incision. She's had all kinds of nerve problems ever since. Is the open operation still better than this new method?
Answer:There's been quite a bit of debate over this question. Open incision carpal tunnel release (OCTR) has been around for 40 years. Endoscopic release has about a 10 year history.
In both operations, the transverse carpal ligament is cut and released. The goal is to take pressure off the median nerve in the wrist. With an open incision, there is a two to three inch cut made. Using the endoscopic approach, the surgeon uses a special tool called an endoscope. A very small incision is made and the endoscope is inserted under the skin.
Even with such a head start, there are only half as many studies on the open CTR compared to the endoscopic CTR. The ECTR has become very popular with surgeons. The rate of complications between the two methods is about the same now. When the ECTR was first developed nerve problems were a major complication.
At this point, it doesn't appear that one method is better than the other. Patient preference and surgeon's choice seem to be the main deciding factors. Problems such as nerve or tendon damage are still possible with either technique.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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