LIGAMENT LENGTHENING COMPARED WITH SIMPLE DIVISION OF THE TRANSVERSE CARPAL LIGAMENT IN THE OPEN TREATMENT OF CARPAL-TUNNEL SYNDROME

It has been suggested that the new (and controversial) endoscopic tech niques are more successful than standard operation for the preservatio n of the ligamentous pulley function across the carpal tunnel and for the separation of the gliding structures from the subcutaneous tissues after release of the carpal ligament in carpal tunnel syndrome. We th erefore decided to study the possible importance of preserving the con tinuity of the carpal ligament by doing an open lengthening of the lig ament. This retrospective, unrandomised study included 99 patients wit h carpal tunnel syndrome who underwent open release of the carpal tunn el with or without a simultaneous lengthening of the transverse carpal ligament. The duration of follow up ranged from 4-8 years. The group who had the ligament lengthened had significantly longer sick leave (p < 0.01) than the group who had transverse ligament section alone. The re were no advantages to reconstruction of the transverse ligament.