Carpal Tunnel Release: Do We Understand the Biomechanical Consequences?

Morrell, Nathan T.; Harris, Andrew P.; Skjong, Christian; Akelman, Edward

doi:10.1055/s-0034-1394363

Cited by 11 publications

(13 citation statements)

References 26 publications

(43 reference statements)

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Section: Discussionmentioning

confidence: 99%

“…31 Morrell et al assumed the etiologies are related to the biomechanical consequences of CTR, including structural alterations, muscle and tendon effects, and neurogenic and edematous effects. 27 The OCTR requires a relatively large incision and causes surgical trauma. The ECTR occasionally makes iatrogenic injury to the median nerve and tendons by inserting a cannula into the pressurized and diseased carpal tunnel, which also increases the deformation of the carpal tunnel.…”

Section: Discussionmentioning

confidence: 99%

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A Clinical Study of the Modified Thread Carpal Tunnel Release

Guo

Guo³

et al. 2016

Hand (New York, N,Y.)

117

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Background: Previous studies have indicated that the thread carpal tunnel release (TCTR) is a safe and effective technique. Through a study on 11 cadaveric wrists, the TCTR procedure was modified and the needle control accuracy was improved to 0.15 to 0.2 mm, which is precise enough to preserve superficial palmar aponeurosis (SupPA), Berrettini branch, and common digital nerves. The aim of the present study was to verify the modified TCTR clinically. Methods: The modified TCTR was performed on 159 hands of 116 patients. The Boston Carpal Tunnel Syndrome Questionnaire was used for assessing the outcomes. Statistical analyses were used to compare the outcomes with the available data from the literature for the open and endoscopic techniques. Results: TCTR led to significant improvement in the short-term results, and the outcomes were better in long-term results compared with the open or endoscopic release. The SupPA, Berrettini branch, and common digital nerves were protected. There was no neurovascular complication for any case. Significant relief of symptoms was observed 3 to 5 hours post procedure. Most patients used their hands on the day of the procedure for simple daily activity. Patients reported their sleep quality was improved on the surgical day. Most patients with office jobs were able to return to work on postoperative day 1, and those with repetitive jobs returned to work in about 2 weeks. The statistical evidence proves that the modified TCTR procedure results in improved clinical outcomes as compared with open carpal tunnel release (CTR) and endoscopic CTR. Conclusions: The TCTR procedure has been shown to be a safe and effective technique for CTR. The modified TCTR procedure minimizes postoperative complications, such as pillar pain, scar tenderness, or functional weakness, by avoiding unnecessary injuries to the surrounding structures around the transverse carpal ligament during the procedure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Clinical Study of the Modified Thread Carpal Tunnel Release

Guo

Guo³

et al. 2016

Hand (New York, N,Y.)

117

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“…In the present case series, the new technique was shown to be effective and very safe, minimizing the two major carpal tunnel surgery complications: scar and pillar pain/tenderness and neuro/vascular/tendinous iatrogenic injuries. Other serious complications, such as complex regional pain syndrome and traction neuropathy, due to perinervous and peritendinous adhesions, 36 were not recorded. No reinterventions were performed.…”

Section: Discussionmentioning

confidence: 99%

‘INSIGHT-PRECISION’: a new, mini-invasive technique for the surgical treatment of carpal tunnel syndrome

Carmo¹

2019

J Int Med Res

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Objective To describe a new mini-invasive surgical technique for carpal tunnel release and to present clinical findings associated with using this technique. Methods Patients with idiopathic carpal tunnel syndrome without prior surgical treatment, who underwent a new minimally-invasive surgical technique using a specific surgical tool-kit developed by the author, were included. Prospective data were collected, including preoperative electrodiagnostic testing. The subjective condition of all patients was evaluated pre- and postoperatively with a five-level Likert-type scale (LS) and muscular strength was tested using a JAMAR dynamometer and pinch gauge. Results A total of 116 patients (157 hands/cases) underwent surgery performed by the author, and were followed for a mean of 40 months (range, 6 months–7 years). Of these, preoperative electrodiagnostic testing was performed in 112 patients (96.6%). No significant complications were reported. By three months, patients reported that they were satisfied or very satisfied in 147/149 cases (98.7%; LS grade I and II). Strength recovery at three months, based on the average of four measures, was 99.17% (range, 97.43–100.97%). Conclusions The described technique is minimally invasive, safe and simple to perform, and provides good results.

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“…Numerous explanations have been presented in the published literature to explain the causation; for instance, structural alterations in carpal tunnel following the release, muscle and tendon effects, neurogenic factors, and edematous effects. The incidence is reported to be 6% to 36% (3,(29)(30)(31).…”

mentioning

confidence: 99%

Presentation and outcome of carpal tunnel syndrome with mini incision open carpal tunnel release

Saaiq

2021

mjiri

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A variety of surgical approaches have been employed to address carpal tunnel syndrome (CTS). Each technique has its attended advantages and disadvantages. The mini-incision technique has recently emerged as promising one among them. →What this article adds:Careful initial evaluation and meticulous surgical decompression of the carpal tunnel with mini-incision provides predictably satisfactory outcome. Patients with diabetes mellitus have more chance of persistent symptoms despite adequate decompression. Hence, they should be counselled preoperatively so as to tailor their expectations accordingly.

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Carpal Tunnel Release: Do We Understand the Biomechanical Consequences?

Cited by 11 publications

References 26 publications

A Clinical Study of the Modified Thread Carpal Tunnel Release

A Clinical Study of the Modified Thread Carpal Tunnel Release

‘INSIGHT-PRECISION’: a new, mini-invasive technique for the surgical treatment of carpal tunnel syndrome

Presentation and outcome of carpal tunnel syndrome with mini incision open carpal tunnel release

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