Carpal Tunnel Release Through a Limited Skin Incision under Direct Visualization Using a New Instrument, the Carposcope

Abstract

A new surgical technique with a set of instruments has been developed for the release of carpal tunnel. The technique allows division of the transverse carpal ligament through a short transverse skin incision (1.5 to 2 cm) of the wrist flexion crease under direct visualization. The technique has been used on 237 patients for 275 cases of carpal tunnel release (38 bilateral). Following the release, median time to activities of daily living was 7 days for 60 compensation patients and 6 days for 193 noncompensation patients (22 patients provided no information on the activities of daily living). The median time to return to work was 49 days for 51 compensation workers and 20 days for 64 noncompensation workers. The overall relief rate of preoperative symptoms was 86 percent (90 percent for noncompensation patients, 82 percent for compensation patients). There were no intraoperative complications among our studies of 275 cases by two surgeons (176 cases by the senior author). The described technique of carpal tunnel release is a useful alternative to open carpal tunnel release because of decreased short-term postoperative morbidity and to the endoscopic carpal tunnel release because of the simplicity and the lower cost of instrumentation.