Endoscopic carpal tunnel release
Keyhole (endoscopic) carpal tunnel release was introduced in the late 1980's and was first carried out in the UK by Mr Erdmann in 1991. Since then he has carried out over 500 procedures.
The advantages of keyhole surgery are:
- The undisputed acceleration of recovery (at 2 weeks return to office work on average, compared to 6 weeks per hand for the standard procedure).
- Less scarring with only two small scars in the hand and the wrist.
- Equivalent efficacy of release and no increase in recurrence rates.
- The ability to operate on both hands at the same sitting, instead of waiting an average of 2 months between hands.
- A light dressing is applied which is changed to two small plasters the next day. This compares with the need for a bulky bandage or plaster cast for the standard technique, needing to be worn for 10 days.
One third of patients having the open technique(standard procedure) will still have some problems at two years. These are usually either weakness of grip, significant pain in the heel of the hand on pushing off and scar tenderness. All of these problems are minimised by endoscopic surgery.
Only about 25% of patients are suitable for this technique however, with the most suitable being patients with bilateral symptoms, no previous carpal tunnel surgery or injury/fracture/scarring of the wrist, and no history of severe inflammatory arthritis eg rheumatoid arthritis. |