gms | German Medical Science

Objectives/Interrogation: Ultrasound-guided carpal tunnel release (UGCTR) is a new minimal-invasive treatment option for patients with carpal tunnel syndrome. Compared with an open procedure it has the advantage to place the incision outside the weight bearing zone and, therefore, to limit the risk of pillar pain. Related to an endoscopic treatment a continuous visualization of the nerve and its related structures is possible.

Methods: UGCTR was performed in twenty Thiel-embalmed cadaver extremities using a U-shaped cutting device with a cutting edge protected by its specific location inside the U. The individual anatomy was sonographically investigated to rule out anatomical abnormalities and to localize the course of the median nerve, the flexor retinaculum (FR) and the superficial palmar arch (SPA) prior to the treatment. A small incision along the distal wrist crease ulnar to the palmaris longus tendon was made, the distal forearm fascia was incised, and the flexor retinaculum was divided under permanent sonographic visualization, changing repeatedly from a longitudinal to a transverse view.

Results and Conclusions: The study was performed using a researcher-blinded protocol. UGCTR was performed by a hand surgeon followed by a dissection by an anatomist to proof the complete separation of the FR and the exclusion of any lacerations of relevant structures. The study results will be presented.

UGCTR allows a controlled dissection of the FR with an permanent visualisation of the median nerve and the SPA. The length of the surgical incision can be reduced and transferred to a non-weight bearing area to limit the risk of postoperative scar tissue pain. Therefore UGCTR seems to have some advantages over an endoscopic or open carpal tunnel release.