Morphologic changes following endoscopic and two-portal subcutaneous carpal tunnel release.

This study describes the morphologic changes that occur following single incision endoscopic and two-portal subcutaneous carpal tunnel release. Seventeen patients were studied preoperatively and an average of 24 weeks postoperatively. Canal volume, carpal arch width, and median nerve palmar displacement and cross-sectional area were measured by use of multiplanar reformation and three-dimensional reconstruction of magnetic resonance images. Both methods produced a marked increase in canal volume and median nerve cross-sectional area; neither resulted in a significant change in carpal arch width. These data provide a morphologic basis for the belief that endoscopic or subcutaneous carpal tunnel release will produce clinical relief equivalent to open carpal tunnel release.

[1]  J. Bennett,et al.  Carpal arch alteration after carpal tunnel release. , 1986, The Journal of hand surgery.

[2]  W. E. Lowry,et al.  Interfascicular neurolysis in the severe carpal tunnel syndrome. A prospective, randomized, double-blind, controlled study. , 1988, Clinical orthopaedics and related research.

[3]  S. Canale,et al.  Campbell's operative orthopaedics , 1987 .

[4]  E. Bigley,et al.  Aberrant index (first) lumbrical tendinous origin associated with carpal-tunnel syndrome. A case report. , 1971, The Journal of bone and joint surgery. American volume.

[5]  S. Mackinnon,et al.  Internal neurolysis fails to improve the results of primary carpal tunnel decompression. , 1991, The Journal of hand surgery.

[6]  K. Backhouse,et al.  Anomalous palmaris longus muscle producing carpal tunnel-like compression. , 1975, The Hand.

[7]  D. Berry,et al.  Endoscopic release of the carpal tunnel: a randomized prospective multicenter study. , 1992, The Journal of hand surgery.

[8]  J. Chow,et al.  Endoscopic release of the carpal ligament: a new technique for carpal tunnel syndrome. , 1989, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[9]  I. Okutsu,et al.  Measurement of pressure in the carpal canal before and after endoscopic management of carpal tunnel syndrome. , 1989, The Journal of bone and joint surgery. American volume.

[10]  B. Rydevik,et al.  Carpal tunnel syndrome: morphologic changes after release of the transverse carpal ligament. , 1989, The Journal of hand surgery.

[11]  C. Schneck,et al.  Carpal tunnel: MR imaging. Part I. Normal anatomy. , 1989, Radiology.

[12]  G. S. Phalen,et al.  Spontaneous compression of the median nerve at the wrist. , 1951, Journal of the American Medical Association.

[13]  A R Hargens,et al.  The carpal tunnel syndrome. A study of carpal canal pressures. , 1981, The Journal of bone and joint surgery. American volume.

[14]  S. Viegas,et al.  Carpal arch alteration and related clinical status after endoscopic carpal tunnel release. , 1992, The Journal of hand surgery.

[15]  Y. Akahoshi,et al.  Carpal tunnel syndrome caused by aberrant lumbrical muscles associated with cystic degeneration of the tenosynovium: a case report. , 1986, The Journal of hand surgery.

[16]  R. Gelberman,et al.  Results of internal neurolysis of the median nerve for severe carpal-tunnel syndrome. , 1985, The Journal of bone and joint surgery. American volume.

[17]  B. Rydevik,et al.  Results of treatment of severe carpal-tunnel syndrome without internal neurolysis of the median nerve. , 1987, The Journal of bone and joint surgery. American volume.

[18]  R. Gelberman,et al.  Peripheral nerve compression: etiology, critical pressure threshold, and clinical assessment. , 1984, Orthopedics.

[19]  C. Schneck,et al.  Carpal tunnel: MR imaging. Part II. Carpal tunnel syndrome. , 1989, Radiology.

[20]  V. Rzetelny,et al.  The flexor digitorum superficialis as a cause of bilateral carpal-tunnel syndrome and trigger wrist. A case report. , 1980, The Journal of bone and joint surgery. American volume.