Neurophysiological Recovery after Open Carpal Tunnel Decompression: Comparison of Simple Decompression and Decompression with Epineurotomy

Author(s): Borisch N, Haussmann P

Source:  J Hand Surg 28B:450-54, 2003.


The authors report on 273 patients with carpal tunnel syndrome who underwent open carpal tunnel release with, or without, epineurotomy.  Patients were examined clinically and by nerve conduction studies preoperatively and at 3, 6 and 12 months postoperatively.  No significant differences were detected between simple decompression and decompression combined with epineurotomy with regard to either the clinical or the neurophysiological outcome.

Previous reports have shown no differences in clinical or neurophysiological results after carpal tunnel decompression with, or without, internal neurolysis (JHS 16A:211-18, 1991; CORR 227:251-54, 1988).  The present study supports a similar conclusion in reference to median nerve epineurotomy.  It is unclear how many studies will be needed, all with similar results, to put this “controversy” to rest.  At present, there is no data to support epineurotomy over simple transverse carpal ligament release for the surgical treatment of carpal tunnel syndrome.


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