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Updated: May 24, 2026

Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
Carpal tunnel release using the MANOS CTR system: preliminary results in 52 patients
Bruce McCormack1, William Bowen, Stephen Gunther
1Department of Neurosurgery, St. Francis Memorial Hospital, San Francisco, USA. rhosel@neurospine.org
Purpose:
To describe a carpal tunnel release technique using the MANOS Carpal Tunnel Release device, with preliminary results in 52 patients.
Methods:
The MANOS Carpal Tunnel Release device is a blade that divides the transverse carpal ligament using wrist and palm skin punctures. The awake patient provides feedback as the surgeon navigates a 2.1-mm-diameter blunt probe across the undersurface of the ligament from a wrist incision with standard disposable nerve stimulator monitoring. The leading tip of the blunt probe is uninsulated and conducts 2 mA. The surgeon converts the blunt insulated probe into an uninsulated blade by advancing a 0.9-mm needle through the palm with a thumb-activated deployment feature. The surgeon saws the ligament through the 2 skin punctures. We used a validated outcome questionnaire to assess postoperative symptoms at 3 months.
Results:
Symptom severity and functional status scores compare favorably with literature controls for open and endoscopic surgery at 3 months. One patient required reoperation for incomplete release. There were no tendon or nerve injuries.
Conclusions:
Preliminary results suggest the MANOS Carpal Tunnel Release device to be safe and effective.
Type Of Study/Level Of Evidence:
Therapeutic IV.
