Abstract
This technique consists of making of two small incisions, one at the distal wrist crease and a second one on the mid-palm 2.5 cm from the first incision. Through these two incisions, the proximal and distal extent of the transverse carpal ligament (TCL) was identified and two specially designed dissector-retractors are introduced. One is isolating the deep surface of the TCL protecting the median nerve. One is isolating the superior surface of the ligament. The TCL is then divided under direct vision.
179 cases were studied from 1996 to 1999 with a minimal follow-up of 3 months. The patients were assessed using the scoring system put forward by Levine et al 1993.
Result: The overall improvement of symptoms is 1.62 points. The average return to activities of daily living was 5.6 days and the average return to work was 4.2 weeks. The complications include 8 pillar pain; 1 transient superficial palmar branch numbness; 1 transient digital branch paraesthesia; 1 retained suture and 2 superficial wound infection.
Conclusions: This new technique shows benefits of small incision surgery similar to endoscopic techniques. It gives direct visualisation of the relevant anatomy. It uses simple and re-useable instruments, and was shown to be safe.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
