This study reviews the results of endoscopic carpal tunnel release on 573 cadaveric hands. The authors performed the Chow 2-incision endoscopic carpal tunnel release procedure and documented the adequacy of ligament release and also complications. The authors indicate that the procedure had a 7% complication rate if the transbursal technique was used and 4% if the extrabursal technique was used. In addition, the authors noted that incomplete release was noted in 30% of specimens using extrabursal technique and 42% of specimen using transbursal technique. These incomplete releases were noted either in the middle or in the distal aspect of the ligament. Complications noted included 1 ulnar nerve injury, 2 median nerve injuries, 8 ulnar artery injuries, 7 superficial palmar arch injuries in 573 cadaver specimens.
This study indicates that there is still a significant learning curve in the use of endoscopic carpal tunnel release procedures. The study was performed in a teaching environment where Orthopaedic surgeons were being taught the procedure. Of note, the reported complications were identified by the course faculty following the procedure. The possibility of occult injuries, not immediately evident to gross dissection, cannot be underestimated.