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Minerva Ortopedica e Traumatologica 2016 March;67(1):8-23

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Future perspectives in carpal tunnel surgery: the state of the art

Bartolomeo SCARSI, Cesare FUSETTI

Hand Surgery Unit Department of Orthopaedics and Trauma Surgery, ORBV‑EOC, Bellinzona, Switzerland


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Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, caused by the compression of the median nerve at the wrist. The median nerve through the carpal channel is tightened as in a grip, due to a pathological thickening of the transverse carpal ligament. This causes tingling, numbness, paresthesia and pain along the path of the nerve towards the fingers. CTS has an incidence of 90% of all the neuropathies and it has a prevalence rate in the population aged between 40 and 60 years and in women. CTS is typically chronic and progressive. Even if CTS mainly seems to be idiopathic, there are several clinical and occupational risk factors. Acute CTS can even occur for a trauma or for a different disease. In this article we analyze the state of the art about the clinical approach, diagnosis tools, challenge tests and patients’ evaluation. We compare conservative and surgical treatments with a particular attention to the three surgical procedures mainly used: open, mini-open and endoscopic carpal tunnel release. We also evaluate the postoperative outcomes and the complications and highlight the effective surgical approaches to re-operate recurrences.

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