Purpose
The purpose of this study was to assess the incidence, outcomes, and complications
associated with conversion from endoscopic carpal tunnel release (ECTR) to open carpal
tunnel release (OCTR).
Methods
A retrospective case review of all patients who underwent ECTR over 4 years by 2 fellowship-trained
hand surgeons at a single academic center was performed. We recorded outcomes and
the reason for conversion in patients who underwent conversion to an OCTR. Baseline
demographics and surgical complications were compared between the 2 groups. A systematic
review was performed to define the incidence and reasons for conversion from ECTR
to OCTR. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines, we included clinical studies of ECTR from 2000 to 2021.
Results
In the retrospective series, 9 of 892 (1.02%) ECTR cases underwent conversion to an
OCTR at the time of the index procedure. One of 9 converted cases had transient neurapraxia
involving the recurrent motor branch after surgery compared with 0 cases in the group
that underwent ECTR without conversion. Improvements in the visual analog scale for
pain and QuickDASH were noted at a mean of 46 weeks after surgery in the group that underwent conversion
to OCTR. The systematic review identified an incidence of conversion of 0.62%. The
most common reasons for conversion to OCTR in the case series and systematic review
were poor visualization due to hypertrophic tenosynovium and aberrant nerve anatomy.
Conclusions
The overall incidence of intraoperative conversion from ECTR to OCTR during the index
procedure was 1.02%, with the most common reasons for conversion being poor visualization
due to hypertrophic tenosynovium and aberrant nerve anatomy. Patients who undergo
conversion from ECTR to OCTR demonstrate improvements in pain and disability, similar
to patients who undergo ECTR without conversion.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: August 13, 2022
Accepted:
June 23,
2022
Received:
February 9,
2022
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
