Emphasis must be on return of sensation and function

EDITOR —I find Ebenbichler et al's paper on ultrasound treatment for carpal tunnel syndrome alarming.1 In my clinical practice as a hand surgeon I see many patients who are permanently disabled by end stage carpal tunnel syndrome: their loss of sensation in the radial digits causes major functional problems with activities of daily living. When treated they eventually become pain free but lose median nerve function.

Surgical treatment is simple and gives good or excellent return of sensation in 80-85% of patients. The cost …