Endoscopic Techniques in the Management of Carpal Tunnel Syndrome

Abstract

Carpal tunnel syndrome (CTS) represents the most common form of peripheral nerve entrapment. Although idiopathic and systemic etiologies are not uncommon, repetitive and stressful wrist motion activities represent a large majority of the cases. Its clinical presentation is classic, and diagnosis can easily be corroborated with electrodiagnostic studies. As a single clinical entity, CTS was not recognized until 1854, when it was first described by Paget (1). His description included a patient who sustained traumatic compressive injury of the median nerve at the distal radius. Subsequently, in 1880, Putnam (2) reported on a series of patients who presented with symptoms consistent with CTS. The first report of surgical release of a compressed median nerve following a traumatic injury was by Learmonth in 1933 (3). In 1946, Cannon and Love (4) first reported the first surgical release of a nontraumatic entrapped median nerve at the wrist. However, beginning in 1950, and during the subsequent two decades, Phalen (5, 6, 7, 8, 9, 10) reported on a large number of patients with idiopathic spontaneous CTS, treated by surgical transection of the transverse carpal ligament. He is acknowledged as single-handedly popularizing the surgical treatment of CTS.