Midpalmar accurate incision for carpal tunnel release

Area of Science:

• Orthopedics
• Neurosurgery
• Hand Surgery

Background:

• Carpal tunnel syndrome (CTS) is the most prevalent entrapment neuropathy.
• Surgical decompression is indicated for CTS cases unresponsive to conservative management.
• Endoscopic carpal tunnel release is increasingly favored for its rapid recovery.

Purpose of the Study:

• To evaluate the efficacy and safety of midpalmar carpal tunnel release with accurate skin incision.
• To compare outcomes of this technique with other surgical carpal tunnel release methods.

Main Methods:

• 96 midpalmar carpal tunnel releases were performed on 84 patients between February 1998 and January 2003.
• Procedures were conducted under regional block or general mask anesthesia.
• Postoperative outcomes were assessed via subjective standardized telephone interviews over an average 22.4-month follow-up.

Main Results:

• The average operative time was 16 minutes.
• 87 hands (91%) achieved excellent or good symptom relief (≥70% improvement).
• Postoperative sensory morbidity (pillar pain/scar tenderness) was 7%; motor morbidity (decreased grip strength) was 8%.
• The average return-to-work period was 4.5 weeks, with no neurovascular or tendinous injuries.

Conclusions:

• Midpalmar carpal tunnel release with accurate skin incision demonstrates efficacy comparable to endoscopic carpal tunnel release.
• This surgical approach is a safe and simple alternative for carpal tunnel syndrome treatment.
• The procedure yields favorable outcomes regarding symptom relief and functional recovery.