Flexor carpi radialis approach for carpal tunnel release

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Surgical Innovation

Background:

• Pillar pain is a common complication following carpal tunnel release surgery.
• The transverse carpal ligament's anatomy presents challenges during surgical division.
• Minimizing disruption to surrounding soft tissues is crucial for reducing postoperative pain.

Purpose of the Study:

• To introduce and evaluate a novel technique for dividing the transverse carpal ligament.
• To decrease the incidence and severity of pillar pain after carpal tunnel surgery.
• To assess the efficacy and safety of using the flexor carpi radialis (FCR) tendon as a guide.

Main Methods:

• A new surgical approach involving direct visualization and division of transverse carpal ligament attachments guided by the FCR tendon.
• Application of the technique in 87 hands undergoing carpal tunnel release.
• Evaluation of preoperative symptom relief, pillar tenderness resolution, and complication rates.

Main Results:

• Complete or partial relief of preoperative symptoms was achieved in 91% (79 out of 87 hands).
• Pillar tenderness resolved rapidly after the procedure.
• The technique demonstrated a low incidence of surgical complications.

Conclusions:

• The FCR-guided approach to carpal tunnel release effectively reduces pillar pain.
• This technique combines direct visualization of carpal canal contents with minimal disruption of palmar tissues.
• The FCR approach offers a safe and effective alternative for carpal tunnel surgery, mitigating common complications.