Safety and Clinical Outcome After Carpal Tunnel Release by a Special Instrument

Abstract

Background: Carpal tunnel syndrome (CTS) is the most common compressive neuropathy of the upper extremity. Surgical treatment by carpal tunnel release is needed after unsuccessful conservative treatment. However, complications such as neurovascular injury and incomplete release of the transverse carpal ligament may occur. Therefore, the authors developed a specially designed instrument for carpal tunnel release surgery, called a CTR knife 1, to avoid such complications. Objective: To demonstrate the safety and clinical outcomes of CTR knife 1. Materials and Methods: A descriptive study of 36 patients diagnosed with moderate to severe CTS by electrodiagnosis that underwent carpal tunnel release surgery were included in the present study. The technique for carpal tunnel release made use of the CTR knife 1 to cut the transverse carpal ligament by limited palmar incision. The wide-awake local anesthesia with no tourniquet technique was used in all subjects. The Clinical outcomes were evaluated by the symptom severity score and functional severity score of the Thai version of the Boston questionnaire. The outcomes were collected preoperatively and 1, 3, and 6 months postoperatively. Results: A significant decrease in both the symptom severity score and functional severity score postoperatively was observed. No life-threatening or serious complications such as permanent median nerve injury, tendon rupture, or infection were observed in the present study. Only two patients (5.6%) reported an unaesthetic scar, and one patient (2.8%) reported a painful scar that subsided after one year. Conclusion: The newly designed CTR knife 1 can be used as a surgical instrument in CTR because it is safe and effective for carpal tunnel release.