The carpal tunnel syndrome is the most frequent entrapment syndrome of 
peripheral nerves. Either a diminution of the volume of the whole carpal tunnel 
or increasement of the intracarpal structures can enhance the pressure on the 
median nerve and so develop a carpal tunnel syndrome. Fibrosis or thickening of 
the synovia of the wrist joint is the most common cause of the syndrome, that 
appears usually in women more than 50 years old. Irradiating pain and sensory 
disturbances are the most frequent subjective complaints. Motoric changes appear 
in a minority of patients with the syndrome. The operative procedure is done 
ambulatory with brachial plexus anesthesia. The subcutaneous 'ramus palmaris 
nervi mediani' should be treated carefully when releasing the transverse 
ligament. After a mean time of 24.1 months, 28 of carpal tunnel syndromes 
treated operatively had a significant amelioration. Seven patients had recurrent 
sensible or motoric complaints, one of them was operated on a second time. 
Postoperative recurrent carpal tunnel syndrome mostly is due to inadequate 
technique or fibrous proliferations.