CARPAL-TUNNEL RELEASE THROUGH A LIMITED SKIN INCISION UNDER DIRECT VISUALIZATION USING A NEW INSTRUMENT, THE CARPOSCOPE

A new surgical technique with a set of instruments has been developed for the release of carpal tunnel. The technique allows division of the transverse carpal ligament through a short transverse skin incision ( 1.5 to 2 cm) of the wrist flexion crease under direct visualization. T he technique has been used on 237 patients for 275 cases of carpal tun nel release (38 bilateral). Following the release, median time to acti vities of daily living was 7 days for 60 compensation patients and 6 d ays for 193 noncompensation patients (22 patients provided no informat ion on the activities of daily living). The median time to return to w ork was 49 days for 51 compensation workers and 20 days for 64 noncomp ensation workers. The overall relief rate of preoperative symptoms was 86 percent (90 percent for noncompensation patients, 82 percent for c ompensation patients). There were no intraoperative complications amon g our studies of 275 cases by two surgeons (176 cases by the senior au thor). The described technique of carpal tunnel release is a useful al ternative to open carpal tunnel release because of decreased short-ter m postoperative morbidity and to the endoscopic carpal tunnel release because of the simplicity and the lower cost of instrumentation.