Ideas and innovations: radial approach to carpal tunnel release in conjunction with thumb carpometacarpal arthroplasty.

Several authors have written about the co-existence of thumb carpometacarpal arthritis and carpal tunnel syndrome, and 4% to 43% of patients undergoing thumb carpometacarpal arthroplasty also have a carpal tunnel release. Some authors advocate that carpal tunnel release and thumb carpometacarpal arthroplasty should be performed at the same time. We perform a combined thumb carpometacarpal arthroplasty and radial approach carpal tunnel release through a single incision. The purposes of this study are to (1) determine the safety of this approach and (2) evaluate the effectiveness of this approach in decreasing the pain and numbness observed prior to surgery. Eight patients had combined thumb carpometacarpal arthroplasty and radial approach carpal tunnel release. With an average follow up of 14 weeks, all patients reported an improvement in pain and numbness. No nerve injuries occurred, and no difficulty in wrist flexion was observed. One patient had pillar pain persisting at 19 weeks follow-up. One patient had basilar thumb pain at 19 weeks, though this was improved over pre-operative levels.