Subligamentous Endoscopic Carpal Tunnel Release: One Portal Technique Using Median Nerve Protector

The safety and efficacy of a reusable median nerve protector designed for use during endoscopic carpal tunnel release were evaluated prospectively in 112 patients (150 palms) with carpal tunnel syndrome. Patients were assessed preoperatively and followed at 1, 3, 6, 12, and 24 weeks postoperatively using the Symptom Severity Scale, Functional Status Scale, wound pain and scar tenderness, monofilament sensory mapping, grip strength measurement, and pin strength gauge. No patients sustained iatrogenic neurovascular injury or hematoma secondary to the procedure, but 3 suffered superficial wound infections postoperatively. Symptom Severity Scores decreased from 3.8 points preoperatively to 2.3 points at 1 week, 1.9 points at 3 weeks, 1.3 points at 6 weeks, and at 1.0 point at 12 and 24 weeks postoperatively. Functional Status Scores dropped from 3.8 points to 2.8 points at 1 week, 2.0 points at 3 weeks, 1.5 points at 6 weeks, and 1.0 point at 12 weeks and thereafter. Semmes Weinstein monofilament mapping improved in all operated hands (108) of the 78 patients not lost to follow up by 24 weeks. Tip pinch testing and grip strength showed gradual improvement as early as 3 weeks postoperatively. The mean value of the postoperative scar tenderness score dropped from 2.4 points at 1 week to 1.7 points at 3 weeks, 1.3 points at 6 weeks, 1.2 points at 12 weeks, and 1.0 point after 12 weeks. In conclusion, this protector provides clear visualization of neurovascular structures intra-operatively; it is a safe and reliable tool for single portal endoscopic carpal tunnel release.

並列關鍵字

endoscopic carpal tunnel release (ECTR) ； median nerve protector

國際替代計量

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