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Micro-invasive ultrasoundguided carpal tunnel release provides excellent outcomes
The goal of carpal tunnel release is to transect the transverse carpal ligament to reduce median nerve compression and relieve pain, numbness and tingling, and improve function. Pre-procedure mapping Once carpal tunnel syndrome is confirmed in patients via electrodiagnostic testing, surgical candida...
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Published in: | Orthopedics Today 2019-03, Vol.39 (3), p.4-9 |
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Main Authors: | , |
Format: | Article |
Language: | English |
Subjects: | |
Online Access: | Get full text |
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Summary: | The goal of carpal tunnel release is to transect the transverse carpal ligament to reduce median nerve compression and relieve pain, numbness and tingling, and improve function. Pre-procedure mapping Once carpal tunnel syndrome is confirmed in patients via electrodiagnostic testing, surgical candidates are scanned in clinic to ensure adequate visualization of major anatomic structures including the following: median nerve (MN); palmar cutaneous branch; thenar motor branch (Figure 1, page 4); third common palmar digital nerve; osseous boundaries of the carpal tunnel (scaphoid, pisiform, trapezium, hook of hamate·); ulnar vessels within Guyons canal; transverse safe zone (TSZ) between the ulnar aspect of the MN and the radial aspect of the ulnar vessels or hook of the hamate (HH), whichever lies more radial·; distal transverse carpal ligament (TCL; Figure 2, page 4)·; and superficial palmar arterial arch (including Doppler)·. [...]of the anesthesia, we use ultrasound guidance to inject local anesthetic into the carpal tunnel within the TSZ - between the MN and ulnar vessels/hamate - to provide anesthesia and hydrodissect the tendons and synovial tissue from the TCL (Figures 3 and 4, page 4). |
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ISSN: | 0279-5647 |