Limited portal with direct-vision carpal tunnel release.

A modified technique of subfascial carpal tunnel decompression is reported. With a small transverse wrist incision, this procedure provides minimal soft-tissue disruption and complete visualization of the carpal ligaments. There is minimal postoperative pain, and the delay in return to work or activities of daily living is greatly reduced. The risks of iatrogenic neurovascular injury or incomplete sectioning of the transverse carpal ligament are virtually eliminated if strict adherence to the technique is observed. Unlike endoscopic carpal tunnel release, it is not a "blind" or "semiblind" procedure and does not require special or expensive instrumentation. On selected patients, this technique is a safe and highly effective alternative of decompressing the carpal canal.