Evidence brief
Carpal Tunnel Syndrome: Outcomes of Surgical Treatment
Surgery superior to splinting for severe CTS
Both open and endoscopic release effective
Endoscopic may have faster return to work
Similar complication rates between techniques
Patient selection important for outcomes
Carpal tunnel release is effective for symptomatic CTS failing conservative management. Both open and endoscopic techniques are acceptable with similar long-term outcomes.
Know surgical anatomy: transverse carpal ligament, motor branch of median nerve variations (extraligamentous, subligamentous, transligamentous). Open vs endoscopic: similar outcomes, endoscopic faster recovery but learning curve. Indications: failed conservative (3 months splinting), thenar atrophy, severe EMG.
Level I
Systematic review of RCTs or high-quality RCT