Endoscopic treatment of carpal tunnel syndrome

After acquiring a consolidated experience in treating carpal tunnel syndrome by resection of the transverse ligament of the carpus by a traditional mini-incision in open surgery using an operating microscope, since 1996 the transverse carpal ligament has been released endoscopically. We have treated 90 patients using a videoscope, two palpators of different diameter, a synovial levator and a pistol handpiece in which the blade group is inserted. Results in terms of symptoms and neurological features were compared with pre-operative findings. Patients without deficit or only sensory impairment had an almost complete recovery in 90% of eases dropping to 69% when a motor deficit was present and to 31% in patients with muscular atrophy. These results are the same as those obtained in patients undergoing open microsurgery, but the recovery of daily activities and the average time elapsed before a return to work are much shorter as the endoscopic technique does not compromise the palmate folds and leaves a minimum scar.