Semivertical Incision: An Aesthetically and Electrophysiologically Effective Mini-Incision Technique for Carpal Tunnel Decompression

Abstract

BackgroundThe purpose of this study was to present the clinical results of our retrospective series of carpal tunnel release (CTR) operations. For these operations we used a unique type of incision, for the first time, for treatment of carpal tunnel syndrome (CTS) consisting of a 1-cm semi-vertical (SV) incision made into the wrist crease for macroscopic open CTR.Material/MethodsThis retrospective study included 114 patients (101 females and 13 males) with CTR who were operated upon in our neurosurgery clinic between December 2010 and June 2015. Patient ages ranged from 35 to 83 years (mean 55.05±12.04 years). In total, 127 hands (73 right and 54 left) were operated upon using the SV skin incision technique. After an average follow-up of 18 months (ranging from 6 to 30 months), clinical and electrophysiological (EP) evaluations were performed.ResultsA review of the English language literature published since 1957, when Phalen first popularised the diagnosis and treatment of this disease, determined that no previous reports of the mini-open incision technique as described in our study have been published. In our retrospective patient case review, we found that after operations using the SV incision technique, statistically significant differences were detected in electromyography (EMG) improvements (p<0.01). In addition, patients who showed improvement in EMG studies (n=90) were satisfied with the result of their surgery.ConclusionsOur study demonstrated that 1-cm skin SV incision was a cosmetically satisfying, fast, and safe approach to CTR that was not only clinically effective but also electrophysiologically effective.

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

“…Published studies have variably reported the affected age groups in their specific populations. For instance, Xu L et al from China reported a mean age of 41 years with a range of 27 to 55 years, whereas Keser N et al from Turkey reported the mean age to be 55 years, with a range of 35 to 83 years (9,10).…”

“…Several published papers are akin to this observation. The higher frequency among women has been attributed to a variety of factors such as the anatomically narrower carpal tunnel being prone to higher internal pressures causing median nerve compression (9)(10)(11)(12).…”

Mini-transverse Incision using Swivel Knife for Treatment of Carpal Tunnel Syndrome: An innovative idea and preliminary report "Amin’s technique"

“…The preoperative diagnosis based on one or more the following manifestations: hand pain, muscle weakness, hypoesthesia or paresthesia among median nerve [MN] distribution, atrophy of thenar muscles and positive signs [Tinel's, Phalen's, or Durkan's] [9] .…”

“…The severity of CTS had graded according to The AAEM classification [10] . All electromyography studies had completed as described by Keser et al [9] .…”

Evaluating the outcomes of median nerve decompression with a mini incision proximal to the distal wrist crease

“…Surgical treatment helps release the MN entrapped under the transverse carpal ligament within the carpal tunnel. Various surgical methods have been described in the literature for this purpose (2,8,10,13).…”