A Closed Case for Carpal Tunnel Syndrome
There is usually more than one way to get something done, even in surgery. Doctors are finding this out with surgery for carpal tunnel syndrome (CTS).

When surgery is needed to release pressure from the median nerve in the wrist, doctors have two choices. They can cut an opening in the palm and wrist, or they can use an instrument called an endoscope to look inside the wrist and release the pressure. The endoscope is slid into the carpel tunnel area through a tiny opening in the skin.

Open surgery, requiring a large incision, has been the first choice for CTS for a long time. However, there have been problems with this surgery. Patients have had muscle weakness, scar tenderness, and pain after open methods of surgery. Sliding an endoscope through the incision and releasing pressure from the nerve has fewer problems afterwards.

The final outcome of CTS surgery (after one year) with either method is the same, but there are two major advantages of endoscopy. Healing time is faster, and people return to work quicker. Since there is no cost difference between these two methods of surgery, more doctors are beginning to recommend endoscopic surgery for CTS.
Thomas E. Trumble, MD, et al. Single-Portal Endoscopic Carpal Tunnel Release Compared With Open Release. In The Journal of Bone and Joint Surgery. July 2002. Vol. 84A. No. 7. Pp. 1107-1115.