Today's News

Thursday, February 13, 1997

Endoscopic procedure speeds recovery

A four-year study of 500 patients has found that the palmar uniportal endoscopic carpal tunnel release results in a rapid return to work and of strength.

Data displayed in the scientific exhibit S 53 shows that eight weeks after surgery, postoperative pinch and grip strengths were near or greater than the preoperative level. Patients' average return to work was 12 days following the procedure.

There also are cosmetic benefits to the procedure, "leaving a cosmetically-appealing scar," said M. Ather Mirza, MD, assistant clinical professor, department of orthopaedics, SUNY, Stony Brook, N.Y., and chief, hand and microsurgery, St. John's Episcopal Hospital, Smithtown, N.Y.

One-third of the patients required no postoperative analgesics with minimal scar, ulnar pillar and radial pillar tenderness, Dr. Mirza said. "The patients also showed no signs of neurovascular injuries to the flexor tendons, median nerve or superficial palmar arch."

Dr. Mirza noted in the scientific exhibit that "there is a concern of a steep learning curve and potential complications when using various techniques of endoscopic carpal tunnel release," but he was able to conclude after the four-year study that "the learning curve was relatively flat using this type of technique."

Dr. Mirza also found the procedure "gives the surgeon the advantage of visualizing the key anatomy prior to division of the transverse carpal ligament.

"The median nerve and superficial palmar arch are directly visualized via the distal incisions in the palm. The flexor tendons and median nerve also are easily visualized endoscopically. This fact accounts for the low complication rate and reasonable learning curve," he said.

Co-author of the study is Eugene T. King, PA-C, orthopaedic clinical instructor, Touro College of Health Sciences, Dix Hills, N.Y., and on staff, department of orthopaedics, St. John's Episcopal Hospital.