Table 1 Eligibility Criteria

Symptoms in at least two digits on one hand (to include thumb, index, middle, or ring finger.)

Wrist or hand surgery within last 6 months

Hand/ wrist symptoms >1 week

Previous CTS release on study hand

Expect to stay in area for 1 year.

Moderate to severe arthritis involving hand or wrist

Willing and able to complete phone interviews

Known tumor, mass, or deformity in the hand or wrist

Over age 18

History of severe trauma to the wrist.

Able to complete questionnaires in English

Pregnant or lactating

Any one of these EDS findings

Motor: Median motor latency (wrist) > = 4.4 ms

Median Motor amplitude <= 3.8 mV

Sensory: median-radial (10 cm thumb to wrist) difference >0.5 ms

EMG (if done) evidence of denervation

Sensory: Midpalm median-ulnar (8 cm) difference >0.3 ms

Evidence of diffuse peripheral neuropathy.

Sensory: Median-ulnar (14 cm digit IV to wrist) difference >0.4 ms

Thenar atrophy

Sensory: Combined Sensory index > = 1.0 ms

(With normal EDS) Night pain that wakes patient AND Positive flick test

Classic, probable, or possible hand pain diagram.

Two consecutive weeks of standard (non-surgical) treatment for CTS, including a trial of wrist splints.

Lack of improvement with conservative treatment documented by at least one of the following:

Improvement less than 0.75 in the CTSAQ functional?

Unable to achieve "satisfactory" level of work

Patient defined symptoms as being "same" or "worse" over the last two weeks.

Willing to schedule surgery within one week of randomization.