Ultrasound-guided percutaneous compartment release: a novel technique, proof of concept, and clinical relevance

Davies, James; Fallon, Valerie; Tun, Jimmy Kyaw

doi:10.1007/s00256-018-3134-y

Cited by 6 publications

(6 citation statements)

References 17 publications

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“…Ultrasound-guided fasciotomy for percutaneous compartment release has been described 40,41. The ultrasound allows for visualization of the superficial peroneal nerve, vessels, and fascia.…”

Section: Operative Management In the Lower Extremitymentioning

confidence: 99%

<p>Chronic exertional compartment syndrome: current management strategies</p>

Buerba¹,

Fretes²,

Devana³

et al. 2019

OAJSM

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Chronic exertional compartment syndrome (CECS) is an underdiagnosed condition that causes lower and upper extremity pain in certain at-risk populations. Lower-extremity CECS is most often observed in running athletes and marching military members. Upper-extremity CECS is most commonly seen in rowers and professional motorcyclists. Although early outcome research on CECS has been based mostly on adult male patients, there has been an increase in the number of studies in pediatric and adolescent patient populations, particularly in females. Evaluation of CECS must include a thorough history and physical exam to rule out other causes of exertional leg pain, but differential diagnosis must remain high on the list. Needle manometry can be used to confirm diagnosis of CECS by measuring intracompartmental pressure. Operative treatment of CECS with fasciotomy has been shown to be effective in resolution of CECS, and new surgical techniques are being developed. In the pediatric population, endoscopy-assisted compartment release has provided high success rates with low complication rates. Nonoperative management of CECS is more commonly described in the literature, and consists of cessation of activities, altering foot-strike pattern, physical therapy, taping, and injections of botulinum toxin A. Nonetheless, larger samples and a more diverse population are needed to better understand the outcomes of nonoperative management. There have been fewer studies on upper-extremity CECS, given its rarity. Success has been found in the treatment of upper-extremity CECS with open fasciotomy, but more studies are needed to understand the efficacy of minimally invasive techniques in the upper extremity. Further research also needs to be done to understand why a large portion (approximately 20%) of the patient population does not experience full resolution of symptoms after fasciotomy.

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“…Ultrasound-guided fasciotomy for percutaneous compartment release has been described 40,41. The ultrasound allows for visualization of the superficial peroneal nerve, vessels, and fascia.…”

Section: Operative Management In the Lower Extremitymentioning

confidence: 99%

<p>Chronic exertional compartment syndrome: current management strategies</p>

Buerba¹,

Fretes²,

Devana³

et al. 2019

OAJSM

View full text Add to dashboard Cite

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“…20 It is associated with lower rates of iatrogenic injury to nerves and ligaments compared to OCTR and ECTR. 21 The TCTR technique can also preserve the superficial palmar aponeurosis (SupPA). SupPA maintenance is essential because several cutaneous nerve branches of the median and ulnar nerves pass through this aponeurosis.…”

Section: Discussionmentioning

confidence: 99%

“… 20 It is associated with lower rates of iatrogenic injury to nerves and ligaments compared to OCTR and ECTR. 21 …”

Section: Discussionmentioning

confidence: 99%

Aesthetic and Functional Outcomes of Open Carpal Tunnel Release and Thread Carpal Tunnel Release: A Randomized Clinical Trial

Akhoondinasab,

Saraee,

Akbari

et al. 2024

Indian J Plast Surg

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Background and Objectives Surgical techniques for carpal tunnel release (CTR) have gradually become less invasive. No substantial evidence supports replacing the open carpal tunnel release (OCTR) with novel minimally invasive approaches. Thread carpal tunnel release (TCTR) is a new minimally invasive CTR method associated with promising results. This study aimed to compare the aesthetic and functional outcomes of OCTR with TCTR. Materials and Methods This study was a randomized clinical trial conducted in a hospital in Tehran, Iran, in 2022. Patients were randomized to OCTR and TCTR groups through simple randomization. Data such as demographics, nerve conduction study, electromyography, pain, and sensory evaluation by monofilament test were recorded in patients at baseline and after 3 months. Aesthetic evaluation was conducted by assessing the scar length and patients' satisfaction 3 months after the surgery. Results Twenty patients (10 in each group) entered the final analysis. Nerve conduction study, electromyography, and sensory evaluation were similar between groups 3 months after the operation. The TCTR group had lower postsurgical pain (p < 0.001) and lower scar length (p < 0.001) compared to the OCTR group. Overall satisfaction was not statistically different between TCTR and OCTR. Conclusion The TCTR method is safe in patients with CTS, and its efficacy is similar to OCTR. It can be a good alternative for OCTR, with a better aesthetic outcome.

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“…In recent years, a novel surgical approach for peripheral compression syndromes has been described in the carpal tunnel [ 5 , 8 , 9 ], cubital tunnel [ 10 ], trigger finger [ 11 , 12 ], and compartment syndrome [ 13 ]: ultrasound-guided thread release (USGTR). Under ultrasound guidance, a cutting thread is looped around the targeted structure and used as a saw to release the compression [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided minimally invasive thread release of Guyon’s canal: initial experience in cadaveric specimens

Jengojan,

Sorgo,

Kasprian

et al. 2024

Eur Radiol Exp

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Objective Guyon’s canal syndrome is caused by compression of the ulnar nerve at the wrist, occasionally requiring decompression surgery. In recent times, minimally invasive approaches have gained popularity. The aim of this study was to assess the efficacy and safety of ultrasound-guided thread release for transecting the palmar ligament in Guyon’s canal without harming surrounding structures, in a cadaveric specimen model. Methods After ethical approval, thirteen ultrasound-guided thread releases of Guyon’s canal were performed on the wrists of softly embalmed anatomic specimens. Cadavers showing injuries or prior operations at the hand were excluded. Subsequently, the specimens were dissected, and the outcome of the interventions and potential damage to adjacent anatomical structures as well as ultrasound visibility were evaluated with a score from one to three. Results Out of 13 interventions, a complete transection was achieved in ten cases (76.9%), and a partial transection was documented in three cases (23.1%). Irrelevant lesions on the flexor tendons were observed in two cases (15.4%), and an arterial branch was damaged in one (7.7%). Ultrasound visibility varied among specimens, but essential structures were delineated in all cases. Conclusion Ultrasound-guided thread release of Guyon’s canal has shown promising first results in anatomic specimens. However, further studies are required to ensure the safety of the procedure. Relevance statement Our study showed that minimally invasive ultrasound-guided thread release of Guyon’s canal is a feasible approach in the anatomical model. The results may provide a basis for further research and refinement of this technique. Key points • In Guyon’s canal syndrome, the ulnar nerve is compressed at the wrist, often requiring surgical release. • We adapted and tested a minimally invasive ultrasound-guided thread release technique in anatomic specimens. • The technique was effective; however, in one specimen, a small anatomic branch was damaged. Graphical Abstract

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Ultrasound-guided percutaneous compartment release: a novel technique, proof of concept, and clinical relevance

Cited by 6 publications

References 17 publications

<p>Chronic exertional compartment syndrome: current management strategies</p>

<p>Chronic exertional compartment syndrome: current management strategies</p>

Aesthetic and Functional Outcomes of Open Carpal Tunnel Release and Thread Carpal Tunnel Release: A Randomized Clinical Trial

Ultrasound-guided minimally invasive thread release of Guyon’s canal: initial experience in cadaveric specimens

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