Surgery of the carpal tunnel. Technical note

Area of Science:

• Orthopedic Surgery
• Neurology
• Hand Surgery

Background:

• Carpal tunnel syndrome (CTS) is a common entrapment neuropathy caused by median nerve compression.
• Nerve enlargement within the carpal tunnel leads to compression, often in the middle section.
• Surgical intervention is the primary treatment for severe or persistent CTS.

Purpose of the Study:

• To describe a modified surgical technique for carpal tunnel release.
• To detail an approach that minimizes risk to the median nerve's sensory branch.
• To present a refined method for carpal tunnel decompression.

Main Methods:

• A modified palmar incision technique is described, starting medial to the palmaris longus tendon at the wrist.
• The surgical approach involves releasing the transverse carpal ligament (retinaculum) from the tunnel's exit towards its entrance.
• Careful dissection is employed to protect the sensory branch of the median nerve.

Main Results:

• The modified technique facilitates surgical decompression of the median nerve within the carpal tunnel.
• The described palmar incision approach aims to prevent iatrogenic injury to the median nerve's sensory branch.
• Retinaculum release from distal to proximal is detailed.

Conclusions:

• The modified surgical technique offers a potentially safer and effective method for treating carpal tunnel syndrome.
• This approach addresses the anatomical challenges of median nerve decompression in the wrist.
• Further studies may evaluate the long-term efficacy and patient outcomes of this modified surgical technique.