115 © Soci~td d'Edition de l'Association d'Enseignement Mddical des H6pitaux de Paris, 1999 Complications and outcome in open carpal tunnel release A 6-year follow-up in 92 patients T. LINDAU 1, M.K. KARLSSON 2 SUMMARY: In this retrospective study, 92 patients (83% attendance rate) were examined 6 years after open carpal tunnel release. A questionnaire was answered by the patient and a physical examination was made by an independent observer. Five complications were found, of which 4 were early postoperative problems and one was a major complication with long-term disability. In one third of the patients numerous complaints were noted even after six years. Recurrences were found in 9 cases. No lacerations of nerves, tendons or vessels were seen and no patient developed reflex sympathetic dystrophy. The overall subjective outcome showed that 91% of the patients were free of symptoms or improved. The grip strength at follow-up was reduced, if the symptoms had been present for more than 12 months, as compared to less than 12 months, (p=0.009) and when associated, unspecific brachialgia had been present (p=0.02). No differences were found in conjunction with the operating surgeon being either an orthopaedic resident or a specialist in hand surgery. In conclusion, open carpal tunnel release had a subjectively favou- rable outcome, but due to complications and postoperative complaints, further investigations into alternative techniques seem necessary. Ann Chir Main (Ann Hand Surg), 1999, 18, n ° 2, 115-121. KEY-WORDS : Complications. - Outcome. - Carpal tunnel syndrome. Carpal tunnel syndrome (CTS) is the most com- mon nerve entrapment syndrome [14, 24] and open carpal tunnel release (OCTR) has been "the golden standard" of treatment since 1951 [33]. Over the years, many variants, such as early postoperative mobilisation [9, 31] and transverse ligament leng- thening techniques [ 17, 19] have been tried. In order to decrease the postoperative problems around the scar, new endoscopic, both uniportal and 2-portal, carpal tunnel release (ECTR) techniques [1, 3, 5, 6, 12, 13, 18, 20, 23, 28-32] have been developed. In response to this, modifications of the standard OCTR have been presented with the limited inci- sion [31] and double incision techniques [37]. Descriptive studies have shown a more rapid return of strength and function with endoscopic and limited incision techniques [26]. However, reports of complications have stirred controversy [27, 32, Manuscrit accept6 d6finitivement le 28 avri11999. 1. Hand Unit, Department of Orthopaedics, University Hospital in Lund, Lund University, S-22185 LUND (Sweden). 2. Department of Orthopaedics, Malm6 University Hospital, MALMO (Sweden).