Ultrasound-guided percutaneous surgery for carpal tunnel syndrome: A cadaver study

Objective: To assess the feasibility of ultrasound-guided surgery for carpal tunnel syndrome. Method: We first studied the ultrasound and anatomic findings in 30 cadaver wrists to determine the best surgical approach and the best plane for releasing the flexor retinaculum. We then used 104 cadaver wrists to assess the feasibility of our technique by performing the surgical procedure then extensively dissecting each wrist and hand. Our evaluation criteria were full release of the transverse carpal ligament and absence of injury to the vessels, nerves, and tendons. Results: The transverse carpal ligament was fully released in all 104 forearms. Full release required a single pass in 61 forearms, two passes in 27 forearms, and three passes in 16 forearms. No injuries to adjacent structures were identified. Conclusions: Our cadaver study supports the feasibility of percutaneous surgery under ultrasound-guidance for carpal tunnel syndrome. (C) 2010 Societe francaise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.