The aim of this study was to describe the single-portal endoscopic technique developed by J. Menon for the treatment of carpal tunnel syndrome and to evaluate its results in our first 82 patients.
Patients and methods: The technique involved insertion of a split cannula into the previously dilated carpal tunnel, followed by section of the transverse carpal ligament from its proximal to its distal edge under visual guidance via a standard arthroscope. No immobilization was used postoperatively. A homogeneous population composed of 82 consecutive patients (71 female and 11 male) with a mean age of 51 years was studied. Mean follow-up was 15 months. A questionnaire was used to evaluate results at last follow-up, and patients were categorized into four groups based on Kelly's criteria.
Results: Fifty one patients (62 per cent) reported complete relief of symptoms and 29 (35 per cent) a substantial improvement, for a total of 97 per cent good and very good results. The symptoms remained unchanged in two patients, of whom one underwent revision. One patient was reoperated because of symptoms due to section of the thenar branch. The arthroscopic procedure was converted to an open procedure in 3.6 per cent of cases.
Discussion: The main advantage of the arthroscopic method is a faster recovery. The method developed by Menon and the material it requires are simple. Complications may be less common than with the two portal method.
Conclusion: The single portal endoscopic technique developed by Menon for the treatment of carpal tunnel syndrome is effective and safe when it is performed in carefully selected patients using a faultless technique.