Ultrasound-guided carpal tunnel release: Anatomical landmarks, surgical technique, and literature review

Carpal tunnel release is one of the most frequently performed procedures in hand surgery, traditionally achieved through open or endoscopic techniques. In recent years, ultrasound-guided carpal tunnel release has emerged as a minimally invasive alternative that combines direct visualization of critical anatomical structures with reduced soft tissue disruption. This technique allows precise identification and protection of the median nerve and its branches, minimizing the risk of iatrogenic injury. Growing clinical evidence suggests that ultrasound-guided release provides outcomes comparable to conventional methods, with the added benefits of shorter recovery time, less postoperative pain, and improved patient satisfaction. In this article, we provide a detailed step-by-step description of the ultrasound-guided carpal tunnel release procedure, highlighting key anatomical landmarks, technical nuances, and device options. Our aim is to offer a reproducible and safe surgical protocol for hand surgeons seeking to integrate this evolving technique into their practice.