C H Lam1, S H Yeung, T C Wong. 1. Department of Orthopaedics and Traumatology, Tseung Kwan O Hospital, Hong Kong.
Abstract
OBJECTIVE: To review the outcomes of endoscopic carpal tunnel release in a Hong Kong public hospital and identify any predictive factors. DESIGN: Retrospective study. SETTING: Regional hospital with a hand surgery service, Hong Kong. PATIENTS: Between January 2001 and December 2007, records of 145 patients (160 carpal tunnel syndromes) having endoscopic release were reviewed. Five major symptom domains (pain, numbness, nocturnal awakening, weakness, and clumsiness) before and after the operation were scrutinised. Functional status was assessed by grading key pinch and hand grip, as well as complications. INTERVENTION: Endoscopic carpal tunnel release using the modified Chow's extrabursal technique under intravenous anaesthesia. RESULTS: After the 160 procedures performed, 124 (78%) and 132 (83%) of them revealed improvement in terms of numbness and nocturnal awakening, respectively. Also, there were significant improvements in terms of average functional grading of pinch power and grip power. No serious complications due to the surgery were encountered. CONCLUSIONS: Experience using the Chow's two-portal endoscopic technique for the treatment of carpal tunnel syndrome in the Chinese population was encouraging. It was a safe and effective method for treating carpal tunnel syndrome. We advocate endoscopic surgical intervention for patients with refractory relief of symptoms following conservative management.
OBJECTIVE: To review the outcomes of endoscopic carpal tunnel release in a Hong Kong public hospital and identify any predictive factors. DESIGN: Retrospective study. SETTING: Regional hospital with a hand surgery service, Hong Kong. PATIENTS: Between January 2001 and December 2007, records of 145 patients (160 carpal tunnel syndromes) having endoscopic release were reviewed. Five major symptom domains (pain, numbness, nocturnal awakening, weakness, and clumsiness) before and after the operation were scrutinised. Functional status was assessed by grading key pinch and hand grip, as well as complications. INTERVENTION: Endoscopic carpal tunnel release using the modified Chow's extrabursal technique under intravenous anaesthesia. RESULTS: After the 160 procedures performed, 124 (78%) and 132 (83%) of them revealed improvement in terms of numbness and nocturnal awakening, respectively. Also, there were significant improvements in terms of average functional grading of pinch power and grip power. No serious complications due to the surgery were encountered. CONCLUSIONS: Experience using the Chow's two-portal endoscopic technique for the treatment of carpal tunnel syndrome in the Chinese population was encouraging. It was a safe and effective method for treating carpal tunnel syndrome. We advocate endoscopic surgical intervention for patients with refractory relief of symptoms following conservative management.