CarpalTunnel Syndrome: EndoscopicCarpalTunnelRelease Al issa Boone , cst L E A R N I N G O B J E C T I V E S s Review the anatomy of the hand and wrist s List the six diagnostic criteria for CTS s Explain the various treatment options used for this condition s Study the surgical steps taken for an endoscopic carpal tunnel release s Compare the Agee Technique and the Chow Technique I N T R O D U C T I O N Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist. It is a narrow, rigid passageway of ligament and bones at the base of the hand. Its contents include the median nerve and the flexor tendons that bend the fingers and thumb. The median nerve provides sensation to the palm side of the thumb and to the index, mid- dle, and part of the ring fingers. Symptoms usually start gradually, with frequent numbness or tingling in those fingers. With CTS, sleep distur- bance is a common complaint. Patients consistently report nighttime symptoms include multiple awakenings due to hand pain and numb- ness. 2 A person with CTS may wake up feeling the need to “shake out” the hand or wrist. 3 With chronic median nerve compression, symptoms Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrap- ment encountered by hand and upper extremity surgeons, accounting for over 600,000 surgeries in the United States annually. 2 The diagnosis was introduced in 1854 when Dr. James Paget first described a case of median nerve compression at the wrist in a distal radius fracture. 1 It was not until 1933 when Dr. Paget performed the first open release of the transverse car- pal ligament. 1 Endoscopic surgery was not performed until 1987 when Dr. Ichiro Okutsu, a Japanese orthopedic surgeon, first reported division of the transverse carpal ligament in a patient with CTS using an endoscope. 2 DECEMBER 2021 | The Surgical Technologist | 543