Early major complications of endoscopic carpal tunnel release: A review of 1200 cases.

Although the early benefits of endoscopic carpal tunnel release have been demonstrated, there is great controversy regarding the risks and safety of the technique. The present study reports early major complications in a series of 1278 consecutive cases performed by a single surgeon over a seven-year period. All procedures were performed under local anaesthesia on an outpatient basis using the Agee single portal technique. Mean follow-up was three months. No vascular, tendon or permanent nerve injuries were documented. Recurrent or persistent symptoms occurred in 7% of patients for which 20 of 89 underwent subsequent open carpal tunnel release. No nerve injuries were found on re-exploration. Other complications were consistent with previously reported incidences. This is the largest reported case series by a single surgeon and represents an accumulation of surgical experience at the upper end of the learning curve. Endoscopic carpal tunnel release is a safe procedure in this experienced single surgeon series.