[Decompression of the carpal tunnel. Apropos of 16 reoperated cases]

The aim of surgery is the healing of disease, and also the preservation or even the reconstruction of the function of an anatomical structure. In 12 out of 16 second look operations after carpal tunnel release we found luxation or subluxation of the intracarpal content. This suggests that the instability created by surgical release of the retinaculum flexorum is an important factor in postoperative symptoms. Therefore we suggest replacing the lengthwise incision of the retinaculum flexorum by widening of this structure. This serves to enlarge the carpal tunnel without forfeiting the function of the retinaculum flexorum. It acts as a pulley, serves as an anchor to the thenar muscles, and allows mechanical protection to the underlying nerve. The satisfactory results obtained after secondary functional reconstructive surgery suggest the same principle should be applied at the first operation.