Ultrasonographically Guided Percutaneous Carpal Tunnel Release: Early Clinical Experiences and Outcomes

• Published in: Arthroscopy Vol. 31; no. 12; pp. 2400 - 2410
• Main Authors: Chern, Tai-Chang, M.D, Kuo, Li-Chieh, Ph.D, Shao, Chung-Jung, M.D, Wu, Tong-Tai, M.D, Wu, Kuo-Chen, M.D, Jou, I-Ming, M.D., Ph.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2015
• Subjects: Adult; Aged; Aged, 80 and over; Carpal Tunnel Syndrome - surgery; Endoscopy - methods; Female; Humans; Ligaments, Articular - surgery; Male; Middle Aged; Orthopedics; Prospective Studies; Treatment Outcome; Ultrasonography, Interventional - methods; Wrist Joint - surgery; Young Adult
• ISSN: 0749-8063; 1526-3231
• DOI: 10.1016/j.arthro.2015.06.023

Purpose To present the technique and results of ultrasonographically guided percutaneous carpal tunnel release (PCTR) in a consecutive series of patients with carpal tunnel syndrome (CTS). Methods We used previously defined landmarks with the “safe zones,” localization, estimated size, and extent of the transverse carpal ligament (TCL) for this prospective clinical study of 91 consecutive cases of carpal tunnel release treated with this technique. The follow-up consisted of 4 time points (1 week and 2, 6, and 12 months) and a final evaluation at an average of 22.5 months. Results The sensory disturbances disappeared in 76.8%, 93.4%, 100%, and 100% of the patients at 1 week and 2, 6, and 12 months postoperatively, respectively. Moderate pain was experienced in 24.2% of patients within 1 week, in 6.6% of patients within 2 months, and in 1.1% of patients within 12 months after the operation. In the final evaluation, 2 hands were graded as unsatisfactory: one hand had moderate wrist pain without sensory disturbance, and one hand had a recurrence 14 months after the operation. There were no intraoperative or postoperative complications. Conclusions Ultrasonographically assisted PCTR is a safe and effective procedure, but it is technically demanding and requires substantial training to be proficient in its use. Level of Evidence Level IV, therapeutic case series.