Original Communications
Complications of endoscopic and open carpal tunnel release*,**,*,**

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Abstract

Separate questionnaires regarding surgically treated complications of endoscopic and open carpal tunnel release over a 5-year period were sent to members of the American Society for Surgery of the Hand to assess and compare major complications of the 2 procedures. Four hundred fifty-five major complications from endoscopic carpal tunnel release were treated by the 708 respondents. This included 100 median nerve lacerations, 88 ulnar nerve lacerations, 77 digital nerve lacerations, 121 vessel lacerations, and 69 tendon lacerations. There were 283 major complications from open carpal tunnel release treated by 616 respondents, including 147 median nerve lacerations, 29 ulnar nerve lacerations, 54 digital nerve lacerations, 34 vessel lacerations, and 19 tendon lacerations. Although this is a retrospective voluntary study with resultant methodologic flaws, the data support the conclusion that carpal tunnel release, be it endoscopic or open, is not a safe and simple procedure. Major, if not devastating, complications can and do occur with both procedures, of which surgeons should be ever cautious. (J Hand Surg 1999;24A:561–565. Copyright © 1999 by the American Society for Surgery of the Hand.)

Section snippets

Materials and methods

Questionnaires were sent to 1,253 members of the American Society for Surgery of the Hand asking for information on complications resulting from OCTR and ECTR treated surgically between 1990 and 1995. (Two identical questionnaires were sent out 1 month apart, the first dealing with complications of ECTR and the second with complications of OCTR.) Respondents were specifically instructed to report only on complications that they had themselves treated surgically. Cases seen in consultation in

Results

Of the 1,253 individuals questioned, there were 708 responses (57%) regarding ECTR and 616 responses (49%) regarding OCTR. Two hundred seventy-nine (39%) of the ECTR respondents reported that they performed ECTR and 587 (95%) of the OCTR respondents reported that they performed OCTR. One hundred seventy-five (63%) of the surgeons performing ECTR reported that they, themselves, had never had a major complication (major nerve, vessel, or tendon laceration), while 532 (91%) of the surgeons

Discussion

Since its introduction, ECTR has generated considerable interest on the part of surgeons and patients as well as considerable controversy. It is generally considered to be a more difficult procedure with greater potential for serious complications than OCTR. Based on the literature, it appears that complications are not common with either procedure.3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 16, 17, 18, 19, 20, 21, 22 We undertook this study to try to validate our clinical experience that there have been

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    *

    No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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    Reprint requests: Andrew K. Palmer, MD, 550 Harrison Center, Suite 128, Syracuse, NY 13202.

    *

    J Hand Surg 1999;24A:561–565

    **

    0363-5023/99/24A03-0005$3.00/0

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    Copyright © 1999 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.