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Palmar uniportal extrabursal endoscopic carpal tunnel release

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      Abstract

      A new technique of endoscopic carpal tunnel release using a 1.5-cm longitudinal palmar incision was used in 280 cases. The incision allows identification of the superficial palmar arch as well as the median nerve and its branches. A new knife/sleeve device that attaches to a standard 4-mm endoscope was created to simplify the procedure. The flexor retinaculum is endoscopically divided proximally into the distal forearm; the “interthenar fascia” (fascia superficial to transverse carpal ligament) can be preserved. Early postoperative results include a mean overall return to work and full activity of 14 days. Postoperative pinch and grip strengths were near or at the preoperative level by weeks after surgery. One third of patients required no postoperative analgesics with minimal scar, ulnar pillar, and radial pillar tenderness.

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