Endoscopic carpal-tunnel release in cadavera. An investigation of the results of twelve surgeons with this training model.

Abstract

Endoscopic carpal-tunnel releases were performed, with use of the two-portal technique described by Chow, on twenty-four fresh or fresh-frozen wrist specimens from cadavera. Twelve surgeons were taught the technique in the cadaver model by an experienced colleague. Nine surgeons performed one endoscopic carpal-tunnel release; three performed three or more. Incomplete release of the transverse carpal ligament was noted in nine specimens (38 per cent). The percentage of incomplete releases was the same for both the surgeons who performed one endoscopic carpal-tunnel release and those who performed three or more. Complications occurred in four specimens (17 per cent) and included lacerations of an ulnar artery and a median nerve, partial laceration of a flexor tendon, and a fracture of the hook of the hamate. The observed complications and incomplete releases of the transverse carpal ligament in this training model emphasize the risks that may occur when a surgeon is first learning this procedure.