Ultrasound-guided percutaneous release procedures in the transverse carpal ligament by acupotomy: A cadaveric study.

OBJECTIVE

This study aimed to determine the safety and accuracy of ultrasound-guided acupotomy percutaneous loosening of the transverse carpal ligament.

METHODS

The 100 upper limb specimens were equally divided into the ultrasound-guided acupotomy group (U) and the nonultrasound-guided acupotomy group (N). For the U group, we simulated ultrasound-guided acupotomy loosening of the transverse carpal ligament in a human specimen, and for the N group, we performed the loosening of the transverse carpal ligament through the same approach under nonultrasound-guided conditions. The safety and accuracy of the two methods were compared through measurement.

RESULTS

In the ultrasound-guided group, the injury rate of nerves, blood vessels and tendons caused by needle-knife release was 0%. In the non-ultrasound-guided group, the rate of nerve, blood vessel and tendon damage was 6 percent, 12 percent and 20 percent, respectively. χ 2 test (Fisher exact test) was performed for the nerve and blood vessel damage rates in the two groups (PN  > 0.05, PA  < 0.05), the difference in nerve damage rates was not statistically significant, but the difference in blood vessel damage rates was statistically significant. Pearson's χ 2 test was performed on the tendon injury rates of the two groups (PF  < 0.05), and the difference was statistically significant. In the ultrasound-guided group, the proportion of acupotomy marks greater than or equal to half of the width of the transverse carpal ligament was 86%, and the non-ultrasound-guided group was 36%. The accuracy of the two surgical methods was tested by Pearson's χ 2 test (PL  < 0.05), and the difference was statistically significant. According to the measurement, the ultrasound-guided acupotomy technology had high safety and accuracy.

CONCLUSION

In this study, we designed a new method for cutting the transverse carpal ligament under ultrasound guidance, which is different from surgery. These results indicate that this is a safe and accurate method of interventional treatment of carpal tunnel syndrome.