Carpal tunnel release: Safe and simple identification of the flexor retinaculum based on superficial anatomical landmarks

Abstract

The aim of our study was to project the borders of the flexor retinaculum (FR) onto superficial landmarks since its insufficient splitting is the most common reason for persistence of symptoms after carpal tunnel release. In 60 hands the radial and ulnar styloid processes were linked by a horizontal line and a longitudinal line was laid through the ring finger's radial side. These were intersected resulting in the reference point "A" on the forearm. As the second basing point "B", the radial margin of the ring finger at the palmar digital crease was chosen. Measurement of the FR was carried out with regard to the reference points. The proximal margin of the FR was located at 4% of the reference line A-B starting from point A and extended up to 52% of this total length. Results indicate that splitting alongside the proximal half of line A-B divides the FR completely. Clin. Anat. 30:512-516, 2017. © 2017 Wiley Periodicals, Inc.

Mini-open carpal tunnel release: technique, feasibility and clinical outcome compared to the conventional procedure in a long-term follow-up

“…The red line represents the longitudinal orientation line to the ring finger, blue marked is the styloid horizontal line. The green line displays the maximal dimension of the transverse carpal ligament as Hohenberger et al have described 14 . MCTR mini-open carpal tunnel release, OCTR Open carpal tunnel release.…”

“…The further magnitude of this minimally-invasive method represents the simple approach and the intraoperative visibility of both structures at danger—namely the thenar branch of the median nerve and the superficial palmar arterial arch. Our method was developed under inclusion of well-known anatomical safe zones 15 – 17 and anatomical landmarks for a mini-open technique as proven by Hohenberger et al in an anatomical study 14 .…”

“…The aim of this study was to evaluate the long-term follow-up of a MCTR based on previously described anatomically landmarks 14 via a palmar approach, and to compare it to the conventional OCTR. Therefore, we hypothesized that the safety and practicability between MCTR and OCTR is similar.…”

The prognostic value of median nerve thickness in diagnosing carpal tunnel syndrome using magnetic resonance imaging: a pilot study

“…If data that includes different levels can be obtained from CTS patients and compared with a control group, much better information can be obtained. Fourth, the cause of CTS has multiple sources, including the transcarpal ligament, soft tissues, and flexor retinaculum [30,31]; however, we only focused on the median nerve. Fifth, because this study is not randomized and is a casecontrol group, an adjustment of baseline characteristics should be considered to compare the two groups.…”