Endoscopic carpal tunnel release. Use of the modified Chow technique in 215 cases.

Abstract

OBJECTIVE: To present my experience using the modified Chow two-portal technique of endoscopic carpal tunnel release. PATIENTS: Two hundred and fifteen patients with a clinical diagnosis of carpal tunnel syndrome of more than three months' duration, unresponsive to conservative treatment. Only those few with the specific contraindications of recurrence, a florid flexor tenosynovitis or an acute crush injury were excluded. INTERVENTION: The operation used the modified Chow two-portal endoscopic method of carpal tunnel release. The original Chow method was used in another 15 patients. MAIN OUTCOME MEASURE: Symptomatic relief of pain and paraesthesia. RESULTS: Most patients made a rapid and dramatic recovery, with an early return to work, when compared with both my and patients' previous experience of open carpal tunnel release. Complications were few--two cases of mild reflex sympathetic dystrophy, two of unrelieved symptoms, and no permanent nerve or tendon injury. CONCLUSION: The modified Chow two-portal technique of endoscopic release of the carpal tunnel is effective, with a rapid recovery and few complications--provided that it is done by a surgeon experienced in this method.