Carpal Tunnel Release with Short Incision

Abstract

A new approach for carpal tunnel release is presented. By means of a specially designed guide, it is possible to completely section the carpal ligament with a short incision without damaging the carpal contents. When the retinaculum has been sectioned and the guide removed by means of three Senn-Miller retractors, one proximally and two laterally, the median nerve is seen perfectly. We performed an anatomic study to determine where the incision should be made to avoid injuring the vascular arch, the cutaneous palmar branch of the median nerve, and the ulnar nerve. We present the results obtained in 112 patients followed up for 1 year. Complaints about tenderness of the scar disappeared, and by the end of the study, patients had regained 126 percent of their preoperative grip strength. All patients were able to use their hands shortly after the operation, and after 3 weeks, all of them returned to work. We think that by using this approach we combine the advantages of the "endoscopic" technique (minimal scar, no tenderness, and early recovery) with those of the classic open technique (exploration of the carpal contents).

The double tunnels technique: an alternative minimally invasive approach for carpal tunnel syndrome

“…It must be considered that other structures such as the vascular branches of the superficial palmar arch, placed within a protective layer of adipose tissue, can also be damaged in this type of approach. 27 Serra et al 30 established that there is a direct relationship between postoperative wrist pain and the extent of subcutaneous adipose tissue damage.…”

Carpal tunnel syndrome: treatment with small transverse incision

“…Limited incision techniques try to combine the simplicity and safety of OCTR with the reduced tissue trauma and postoperative morbidity of ECTR by using a short incision. A variety of techniques has been described such as: approaches using two incisions, palmar incision with distal to proximal FR opening, palmar and wrist oblique and longitudinally oriented incisions or using auxiliary tools such as translumination [16][17][18] . Some authors report approaches through small proximal transverse incisions but those differ from the technique presented herein regarding both the instrumentation used and the differing landmarks and safety parameters adopted [19][20][21] .…”

Does Carpal Tunnel Release Provide Long-Term Relief in Patients with Hemodialysis-Associated Carpal Tunnel Syndrome?

“…For all other patients, a standard pneumatic tourniquet was applied at the upper arm. For all patients, we used the limited open approach to release the transverse carpal ligament as previously described [4,15]. We made a longitudinal incision from Kaplan's cardinal line, 3 to 4 mm ulnar to and parallel with the thenar crease, 3 cm long toward the ulnar border of the palmaris longus tendon.…”

“…Surgical release of the transverse carpal ligament is commonly performed in patients with severe symptoms of hemodialysis-associated CTS [6,9,13,[15][16][17][18]. Approximately 5% of patients receiving hemodialysis have reported a history of carpal tunnel release [16].…”