Current Surgical Trends in Carpal Tunnel Syndrome

This review highlights current surgical approaches for carpal tunnel syndrome (CTS), the most common compressive neuropathy of the upper extremity. Open, mini-open, endoscopic, and emerging minimally invasive techniques are compared in terms of outcomes, complications, pillar pain, and reoperation rates. Surgical indications, anatomical considerations, and management of recalcitrant CTS—including recurrent, persistent, and new-onset symptoms—are discussed. Adjunct procedures such as opponensplasty and flexor synovectomy are reviewed, with emphasis on patient selection, individualized decision-making, and the importance of thorough anatomical knowledge to ensure safe adoption of novel techniques.