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Journal of Hand Surgery (British and European Volume)
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*Carpal Tunnel Syndrome
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Articles

Comparison of Proximal and Distal One Portal Entry Techniques for Endoscopic Carpal Tunnel Release

A cadaver study

T. TSURUTA
S. A. SYED
T. TSAI

From the Christine M. Kleinert Institute for Hand and Micro Surgery, Louisville, Kentucky, USA

Correspondence: Tsu-Min Tsai, MD, Christine M. Kleinert Institute for Hand and Micro Surgery, One Medical Center Plaza, Suite 850, 225 Abraham Flexner Way. Louisville, Kentucky 40202, USA.

Reported complications of endoscopic carpal tunnel release have increased as more surgeons use this technique to release the flexor retinaculum. We used a cadaver model to compare the results of endoscopic carpal tunnel release through a one-portal distal (Group A, 15 specimens) and a one-portal proximal (Group B, 15 specimens) entry site with a new endoscopic technique. Our custom-made glass tube of three different sizes (5, 7, and 9 mm in diameter) is designed to house an endoscope and accommodate a meniscus knife for releasing the flexor retinaculum. Complete release of the flexor retinaculum was obtained in all limbs in both groups. In Group A the one complication (7%) was loss of the cotton tip from the cotton swab stick within the carpal tunnel. In Group B, there was a single case of injury to the superficial palmar arch in one hand and breakage of a glass tube in another hand, for a total complication rate of 13%. No other damage to anatomical structures was noted.

Journal of Hand Surgery (British and European Volume), Vol. 19, No. 5, 618-621 (1994)
DOI: 10.1016/0266-7681(94)90129-5
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