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KMID : 0948920060050020101
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Clinical Pain
2006 Volume.5 No. 2 p.101 ~ p.105
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Surgical Treatment of Carpal Tunnel Syndrome
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Lee Kwang-Hyun
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Abstract
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No matter what technique or incision is used to perform the surgery, the common maneuver of all permutations of carpal tunnel release is transection of the transverse carpal ligament (TCL). When transecting the TCL, the safest zone of dissection is along the ulnar side of the ligament near its attachment. Injuries to the ulnar neurovascular structures, superficial palmar arch, recurrent motor branch of the median nerve, and cutaneous median nerve branch have all been reported during the operation. Carpal tunnel release by any method, open, endoscopic, and limited open with or without specialized instruments have all had reports of major complications and there is no evidence showing superiority in the final outcome of endoscopic versus traditional open methods. The incidence of recurrent or persistent symptoms after carpal tunnel release range from 1% to 20%. Reasons for failure to relieve symptoms include incomplete release, wrong diagnosis, double crush syndrome, peripheral neuropathy, persistent carpal canal space occupying lesions and iatrogenic median nerve injury.
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KEYWORD
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Surgical treatment, Carpal tunnel syndrome
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