To explore the clinical efficacy of ultrasound-assisted percutaneous channel release in the treatment of chronic carpal tunnel syndrome.

Retrospective analysis was conducted on patients with carpal tunnel syndrome treated in the Department of Hand and Foot Surgery, the People's Hospital of Danyang from November 2020 to December 2023， who met the inclusion and exclusion criteria. Among them， 26 cases underwent ultrasound-assisted percutaneous channel release （ultrasound group） and 40 cases underwent a small longitudinal incision （small incision group） at the palm base for carpal tunnel release. Surgical time， incision length， and postoperative recovery were recorded and compared.

There was no statistically significant difference in surgical time between the two groups （P>0.05）； the surgical incision length in the ultrasound group was shorter than that in the small incision group， showing a statistically significant difference （P<0.001）； follow-up at 3 months postoperatively using Gu Yudong's postoperative functional evaluation criteria for carpal tunnel syndrome indicated satisfactory surgical outcomes， with marked improvement in numbness， pain symptoms， sensory tests and grip strength in both groups， with no statistically significant difference between the ultrasound group and the small incision group （P>0.05）； early postoperative columnar pain did not occur in the ultrasound group， while 2 cases occurred in the small incision group. There was no statistically significant difference in the postoperative Boston carpal Tunnel Questionnaire (BCTQ) scores between the two groups （P>0.05）.

Ultrasound-assisted percutaneous channel release for chronic carpal tunnel syndrome allows precise cutting of the thickened transverse carpal ligament while reducing tissue damage， effectively relieving median nerve compression. It has advantages such as accurate incision placement， short scarring， and minimal early columnar pain， making it a surgical option for the treatment of carpal tunnel syndrome.