Related Experiment Video
Updated: May 2, 2026
Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
Carpal tunnel release using the Paine retinaculotome inserted through a palmar incision
Carlos Henrique Fernandes1, Luis Renato Nakachima1, Celso Kiyoshi Hirakawa1
1Hand Surgery Group, Department of Orthopedic Surgery, Universidade Federal de São Paulo, Rua Borges Lagoa 1065, cj 68/69, Sao Paulo, Sao Paulo CEP 04038-032 Brazil.
Background:
Carpal tunnel syndrome (CTS) is the most commonly diagnosed and treated entrapment neuropathy. There is no consensus regarding the optimal technique for carpal tunnel release. The objective of this study is to demonstrate the surgical treatment of CTS by a small palmar incision and utilization of Paine retinaculotome to divide the transverse carpal ligament.
Methods:
In this technical note, we describe the use of a retinaculotome described by Paine in 1955, through a palmar approach.
Discussion:
Open, minimally invasive and endoscopic surgical techniques have all been described as treatment options for CTS, and short-term success with these methods is well established. During the last decade, less invasive techniques have been developed in order to reduce the incidence of pillar pain and tender scars. We have used a mini-palmar incision and the Paine retinaculotome for carpal tunnel release since 1994. The goals of surgery are to create a small incision that permits a patient to have early motion and return to activity.
Conclusion:
After many years, no permanent nerve or vascular damage has been reported. This method has demonstrated itself to be efficient and safe in the treatment of the carpal tunnel syndrome.
