13-Year Experience of Carpal Tunnel Release Using the Indiana Tome Technique

Lee, W.P. Andrew; Schipper, Bret M.; Goitz, Robert J.

doi:10.1016/j.jhsa.2008.03.013

Cited by 12 publications

(15 citation statements)

References 24 publications

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“…35 Comparative operative time using the mini-open and endoscopic techniques is controversial and may be surgeon dependent. 25,31 Improvements in disability are equivalent between the open and endoscopic approaches at 3-month, 5-year, and 12-year follow-up. [2][3][4] Review of the American Board of Orthopaedic Surgery database from 2003 to 2013 found the complication rate of open and endoscopic carpal tunnel release to be 3.6%.…”

Section: Discussionmentioning

confidence: 93%

“…10,12,18,26 Carpal tunnel release is routinely performed via the traditional open approach, mini-open approach, or endoscopic approach with high rates of success. 5,6,23,25,30,32,35 There is controversy between the relative merits of the three surgical approaches. The traditional open approach, although safe from a structural standpoint, 24,35 is associated with scar tenderness, pillar pain, burning discomfort, and a longer time to return to work.…”

Section: Discussionmentioning

confidence: 99%

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Rates of Complications and Secondary Surgeries of Mini-Open Carpal Tunnel Release

Zhang

Blazar

Earp

2018

Hand (New York, N,Y.)

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Rates of Complications and Secondary Surgeries of Mini-Open Carpal Tunnel Release

Zhang

Blazar

Earp

2018

Hand (New York, N,Y.)

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“…Initial data from a clinical trial suggested an iatrogenic median nerve injury rate of zero using the Agee method (Agee et al, 1992), yet statistics from a study by Schonauer et al (2003) suggest injury in 0.53% of cases. Both endoscopic procedures include the risk of the learning curve associated with the surgical equipment as well as the possibility of converting the endoscopic technique into an open technique when complications arise, many of which are associated with anatomical variations of the median nerve (Lee et al, 2008; Schonauer et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

The most commonly injured nerves at surgery: A comprehensive review

et al. 2020

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Iatrogenic nerve injury during surgery is a major source of concern for both patients and surgeons. This study aimed to identify the nerves most commonly injured during surgery, along with the commonly associated operative procedures. A literature search was conducted using the PubMed database to identify nerves commonly injured during surgery, along with the surgical procedure associated with the injury. The following 11 nerves, ranked in order with their associated surgical procedures, were found to be the most commonly injured: (a) intercostobrachial nerve in axillary lymph node dissections and transaxillary breast augmentations, (b) vestibulocochlear nerve in cerebellopontine tumor resections and vestibular schwannoma removals, c) facial nerve in surgeries of the inner ear and cheek region, (d) long thoracic nerve in axillary lymph node dissections, (e) spinal accessory nerve in surgeries of the posterior triangle of the neck and cervical lymph node biopsies, (f) recurrent laryngeal nerve in thyroid surgeries, (g) genitofemoral nerve in inguinal hernia and varicocele surgeries, (h) sciatic nerve in acetabular fracture repairs and osteotomies, (i) median nerve in carpal tunnel release surgeries, (j) common fibular nerve in varicose vein and short saphenous vein surgeries, and (k) ulnar nerve in supracondylar fracture surgeries. Although the root cause of iatrogenic nerve injury differs for each nerve, there are four unifying factors that could potentially decrease this risk for all peripheral nerves. These four influencing factors include knowledge of potential anatomical variations, visual identification of at‐risk nerves during the procedure, intraoperative nerve monitoring, and expertise of the surgeon.

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“…Other minimally invasive carpal tunnel release tools such as the Indiana Tome (Biomet, Warsaw, USA), the KnifeLight (Stryker Instruments, Kalamazoo, Michigan, USA), and the "Safeguard" system (KMI, Inc., San Diego, USA) have been developed to minimize incision and soft tissue damage [12,27]. With limited literature, a review of minimally invasive carpal tunnel release with these assistive tools demonstrated an early recovery outcome and minimal complication [12,28,29]. However, unlike the Wongsiri MIS technique, those surgeons had a limited visual field during operation and because of this limitation, instances occurred of incomplete TCL release and could not demonstrate effective safety along the compressed area of median nerve [7,16].…”

Section: Discussionmentioning

confidence: 99%

“…e major noteworthy complications of endoscopic carpal tunnel release are nerve injury, which include transient nerve problem and nerve transection [6,11]. In contrast, other minimally invasive techniques with limited visualization, with and/or without special tools such as the Indiana Tome (Biomet, Warsaw, USA), the KnifeLight (Stryker Instruments, Kalamazoo, Michigan, USA), and the "Safeguard" system (KMI, Inc., San Diego, USA) have individually shown simplified operative techniques but each also has a limited visual field, and notably, some literature describes safety risks and evidence of incomplete transverse carpal ligament (TCL) release [12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Carpal Tunnel Release (CTR) Using the Wongsiri Technique with MiniSURE

Wongsiri

Liawrungrueang

2020

Advances in Orthopedics

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Introduction. The standard open technique for carpal tunnel surgery has wound problems and complications significantly more than minimally invasive surgery using the Wongsiri technique with MiniSURE Kit® (Surgical Innovation Healthcare Co., Ltd, Bangkok, Thailand) and in particular, the open technique surgery requires a longer time for return to work. CTR surgery with endoscopic devices improves the results with fewer wound problems when compared with the commonly used open technique; however, nerve complications and injury are more prevalent with endoscopic surgery than with the open technique. The Wongsiri technique produces good results with new medical devices such as the MiniSURE View, for improved vision and line-of-sight, and the MiniSURE Cut for improved and complete cutting via the supraretinacular technique that may reduce the nerve problems associated with endoscopic tooling in the carpal tunnel. Purpose. To evaluate the results of the operation and postoperative outcomes of the Wongsiri technique with a MiniSURE Kit®. Methods. 20 patients underwent carpal tunnel release using the Wongsiri technique and a MiniSURE Kit® with a five-step surgery: MIS starts when the surgeon makes a 1.5–1.8 cm incision, creates a working space, inserts the visual tube of MiniSURE View, inserts the freer, and then cuts the transverse carpal ligament by using the MiniSURE Cut. Results. All 20 successes of the Wongsiri technique and MiniSURE Kit® surgery occurred within 6.8 minutes operative time and a 12 mm wound size. A single outlier, in one case (6.7%), the patient experienced pillar pain which abated within one month. Patients can return to work in 7.3 days. Conclusions. The Wongsiri technique with the MiniSURE Kit® demonstrated good outcomes similar to the endoscope. By contrast with the endoscopic surgery, the Wongsiri technique with the MiniSURE Kit® reduced preop, operating, and postop time, many resources, and significant costs and resulted in no nerve problems or complications.

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13-Year Experience of Carpal Tunnel Release Using the Indiana Tome Technique

Cited by 12 publications

References 24 publications

Rates of Complications and Secondary Surgeries of Mini-Open Carpal Tunnel Release

Rates of Complications and Secondary Surgeries of Mini-Open Carpal Tunnel Release

The most commonly injured nerves at surgery: A comprehensive review

Minimally Invasive Carpal Tunnel Release (CTR) Using the Wongsiri Technique with MiniSURE

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