Infection Rates Following Ultrasound-Guided Microinvasive Carpal Tunnel Release: A Single-Practice Cohort Study

Purpose Postoperative infection following carpal tunnel release (CTR) is uncommon, although reported rates vary because of differences in outcome definitions and follow-up methodology. As ultrasound-guided and microinvasive CTR techniques continue to emerge, infection-specific outcomes remain inconsistently reported. The purpose of this study was to determine the rate of clinically significant postoperative infection following ultrasound-guided microinvasive CTR (Micro-CTR) and to contextualize this rate against published benchmarks. Methods A retrospective cohort study was performed of consecutive adults undergoing office-based ultrasound-guided Micro-CTR in a single practice. All procedures were performed under local anesthesia using a standardized ultrasound-guided technique with percutaneous access and real-time visualization of the transverse carpal ligament and surrounding neurovascular structures. The primary outcome was clinically significant infection, defined as infection involving the palmar compartment requiring medical or surgical intervention. Secondary outcomes included localized superficial infection at the puncture site. Infection rates were calculated with 95% confidence intervals and compared descriptively with published data across CTR techniques. Results A total of 476 patients contributed 533 procedures. Clinically significant infection occurred in one case (0.19%; 95% CI, 0.005–1.04). No localized superficial infections were identified. No cases required hospital admission or additional operative management. The observed rate was interpreted descriptively alongside published infection benchmarks across CTR techniques. Conclusions Clinically significant infection following ultrasound-guided Micro-CTR was rare in this single-practice cohort. The observed rate was interpreted descriptively alongside published benchmarks across established CTR techniques. Standardized, clinically meaningful outcome definitions may improve comparison of infection risk as less invasive approaches continue to emerge. Type of study/level of evidence Therapeutic IV.