Application of Endoscopy to Treatment of Carpal Tunnel Syndrome / 中国微创外科杂志

ABSTRACT

Objective To study the indications of endoscopic treatment for carpal tunnel syndrome(CTS).Methods From July 2004 to September 2007,21 patients(24 wrists) with CTS received endoscopic treatment in our hospital.Under local anesthesia,an 1-cm incision was made at the level of the proximal transverse wrist crease ulnar to the palmaris longus tendon.A special cannula was inserted into the carpal tunnel,and then the transverse carpal ligment was cut and the median nerve was decompressed.All the patients were re-examined in 1,2,3,and 5 months postoperation.Results According to the criteria of Kelly,11 cases achieved excellent outcomes in 5 months,meanwhile 6 were good,2(3 wrists) were fair,and 2 were poor.One of the 2 poor cases received a second operation by traditional procedures(nerve release) 7 months after the first surgery,another case were treated by conservative therapy because of sympathetic symptoms.Conclusions ① Endoscopy is the first choice for idiopathic cases,while open surgery should be performed on secondary cases(rheumatic synovitis,fracture deformity,tumar,inflammation,gout,neurodegenerative desease etc.).② The carpal tunnel release should be used for patients with abnormal opponens function of the thumb,as well as advanced cases.③ Routine operation are the first choice for eldly patients but not for the younger ones.