Endoscopic Carpal Tunnel Release Experience at King Hussein Medical Center

Objective: To describe the results of the endoscopic carpal tunnel release using the MicroAire Carpal Tunnel Release System. Methods: This descriptive study was conducted from June 2007 to May 2009 on 63 patients (68 hands) who underwent endoscopic carpal tunnel release for severe carpal tunnel syndrome in the Royal Jordanian Rehabilitation Center at King Hussein Medical Center. The procedure was performed using the MicroAire Carpal Tunnel Release System by an experienced hand orthopaedic surgeon. This is a new procedure performed for the first time in Jordan at King Hussein Medical Center. The operating time was between 10-25 minutes. The indications for carpal tunnel release are severe carpal tunnel syndrome diagnosed clinically and by nerve conduction studies and lack of response to conservative treatment using Futuro splinting and ultrasound physiotherapy for more than three months. Results: Endoscopic carpal tunnel release provided complete relief of parasthesia on the first day and relief of wound pain during the first three days. Return to work after this procedure was between 4 to 22 days with a mean return time of 9 days. Three patients were converted to open technique because the flexor retinaculum and the median nerve could not be visualized. One patient had alkaptonuria and the other two had blood inside the carpal tunnel due to failure of Bier's block and release of the tourniquet. They were excluded from the sample and the study was conducted upon 65 hands. The complication rate among the study group was 7.6%. On the other hand, no vascular injuries and no major nerve injuries were reported. Complete relief of symptoms occurred in 93.8% of the study group. Conclusion: This procedure is an effective, safe and convenient procedure for the treatment of carpal tunnel syndrome in the hand, associated with less palmar pain, less scar tenderness, a high return to work rate and an extremeley low complication rate. It is a quick procedure with good results in short-term postoperative rehabilitation.