Case report: Ultrasound-guided needle knife technique for carpal ligament release in carpal tunnel syndrome treatment

Abstract

Carpal tunnel syndrome (CTS) is a common peripheral neuropathy of the hand, mainly manifesting as sensory disturbances, motor dysfunctions, and pain in the fingers and hand. The pathogenesis of the disease is associated with fibrosis of the transverse carpal ligament in the carpal tunnel, which compresses median nerve. In our case, we demonstrate an ultrasound-guided needle knife technique to treat CTS. We guided the patient to a supine position on the examination table. The skin of the wrist area was sterilized for the procedure. After the skin was dry, we positioned sterile drapes, located the median nerve and compression, and marked the compression point. Local anesthesia was administered. An ultrasound-guided needle knife was inserted. The needle knife was advanced under ultrasound guidance. The carpal ligament was incised. A gradual release of pressure on the median nerve was observed on the ultrasound monitor. After treatment, the patient’s finger sensation and motor function can significantly improve, and pain symptoms are markedly reduced, this case demonstrates that small needle-knife treatment can serve as a safe and effective minimally invasive therapeutic method.

Superficial thrombophlebitis in the forearm leading to entrapment of the radial nerve branch: a first case report and literature review

“…The combination of MR or ultrasound imaging and electrical diagnosis research can realize more accurate initial diagnosis and timely treatment [ 16 ]. Although the prognosis of compression neuropathy depends on the degree of nerve injury, early surgical intervention is very important [ 17 , 18 ]. In this case, the superficial branch of the radial nerve was compressed by a thrombotic superficial vein, so the right forearm radial nerve compression release and hemangioma resection were performed.…”

Comparative Efficacy of Micro-Needle-Knife Therapy and Acupuncture in Acute Ankle Sprains: A Randomized Controlled Trial

“…Guo et al [ 33 ] treated 38 patients with periarthritis of the shoulder, using MNK to release the superficial fascia at critical sites, including the coracoid (attachment point of the short head of the biceps), small tubercles (subscapularis attachment points), intertubercular sulcus (long head of the biceps attachment point), subacromial bursa (supraspinatus attachment point), and the greater tubercle of the humerus (teres minor attachment point), resulting in enhanced shoulder function and reduced coracohumeral ligament thickness. Sun et al [ 34 ] presented a pathological report on a patient with carpal tunnel syndrome, noting that MNK release of the fibrotic superficial fascia within the carpal tunnel improved finger mobility and pain after just 1 treatment. Moreover, 2 systematic reviews and meta-analyses have respectively evaluated the evidence for MNK treatment of plantar fasciitis [ 35 ] and post-herpetic neuralgia [ 36 ], both endorsing its clinical safety and superior efficacy in treating acute or chronic soft tissue traumatic diseases.…”