The indiana tome for carpal tunnel release

Consequent to persistent debate over endoscopic versus open carpal tunnel release,a minimally invasive technique was developed which combines the reduced tissue trauma and postoperative morbidity of endoscopic release with the simplicity and safety of the traditional open technique.After Chow described an endoscopic technique of carpal tunnel release in 1989, several modifications of his approach were developed including the use of video equipment for visualization ofthetransversecarpalligamentandspeciallydesigned instruments [1-8].The clinical efficacy of the endoscopic release was found to be equivalent to that of open carpal tunnel release [4, 9,10].Proponents of endoscopic release claim a reduction in postoperative morbidity as less tissue is surgically violated [11, 12]. A multicenter randomized prospective study comparing open and endoscopic carpal tunnel releases showed greater grip and pinch strength and less scar and pillar tenderness at various early postoperative period in patients who underwent endoscopic release [4 ].In addition,endoscopic patients were found to have earlier return to activities of daily living (median 5 days versus 13 days)and to work (16.5 days versus 45.5 days) [4]. Another multicenter randomized prospective study corroborated the findings of less scar tenderness and reduced time out of work (median time of 14 days versus 28 days)in patients following the endoscopic procedure [9].Additionally,the advantages of both one and two-portal endoscopic releases compared with open release in postoperative parameters of tenderness,grip and pinch strength,as well as return to normal activities were demonstrated in another study [10]