[Carpal tunnel release with minimal incisions. Evaluation of the technique in fresh cadaver models].

OBJECTIVE

To assess the carpal tunnel release technique with minimal incisions, blindly, based on the portals of Chow's endoscopic technique in fresh cadaver models.

MATERIAL AND

METHODS

From January 2007 to June 2009, 23 carpal tunnel releases were performed in fresh cadavers, using Chow's endoscopic portals. A malleable retractor and a fluted probe were introduced and the transverse carpal ligament was released with a retrograde scalpel from distal to proximal. We then meticulously dissected the palmar region and the anterior aspect of the forearm under magnification. We recorded the possible injuries to neurovascular and tendinous structures and whether the ligament release had been complete or incomplete, as well as the anatomical variants found. All the procedures were performed by the first author.

RESULTS

21 complete transverse carpal ligament releases were performed (91.3%). In two specimens the release of the thenar-hypothenar fascia was incomplete. We found the type I Lanz anatomical variant in one specimen and the type III in two. No associated neurovascular or tendinous injuries were reported.

FINAL REMARKS: Transverse carpal ligament blind release with minimal incisions should be taken with reservations. With proper training it may be a practical and low cost procedure for the treatment of carpal tunnel syn- drome in our hospital setting. It may be performed quickly, with minimal scars and may decrease the recovery time and the loss of grip strength.