Single Portal Endoscopic Carpal Tunnel Release in Patients Older than 65 Years

Koh,  Il Hyun; Lee,  Jeong Gil; Choi,  Yun Rak; Kim,  Hyung Sik; Kang,  Ho Jung

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Journal of the Korean Society for Surgery of the Hand 2010;15(4):169-174.
Published online December 1, 2010.

Single Portal Endoscopic Carpal Tunnel Release in Patients Older than 65 Years

Il Hyun Koh, Jeong Gil Lee, Yun Rak Choi, Hyung Sik Kim, Ho Jung Kang

¹Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea. ysos111@yuhs.ac
²Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

Abstract

Purpose
There have been few reports about the endoscopic carpal tunnel release (ECTR) in elderly patients and its efficacy and safety are not well-known. We evaluated the clinical outcomes of ECTR using Agee technique in patients older than 65 years. MATERIALS AND METHODS: From October 2000 to January 2007, thirty-five patients (42 hands) who underwent ECTR using Agee technique were enrolled. The average age of the patients was 67.2 years (range, 65-71 years). The duration of symptoms averaged 10 months (range, 6-33 months). For evaluation of the clinical outcomes, physical examination and subjective assessment of the hand function using the Boston carpal tunnel questionnaire were performed at postoperative 1-year follow-up and compared with those obtained at preoperative evaluation. The mean follow-up period was 18 months (range, 12-24 months).

Results
There were no neurovascular injury and scar tenderness. At postoperative 1-year follow-up, paresthesia, numbness, Phalen's sign, tinel sign, two point discrimation, and grip power were significantly improved compared with those obtained at preoperation. According to the Boston questionnaire, symptom severity score improved from 3.43 preoperatively to 1.89 postoperatively, and functional status score improved from 3.18 preoperatively to 2.21 postoperatively (p<0.05). Thenar atrophy still remained in 32 hands (76.2%).

Conclusion
Although thenar atrophy did not improve in many cases, symptom severity and functional status scores improved in most patients treated with ECTR. The single portal ECTR is a safe and efficacious treatment option in elderly patients with carpal tunnel syndrome.

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