Abstract
Aim: To investigate the efficacy and safety of a two-tunnel technique for the decompression of the carpal tunnel.
Method: The technique consists of making two small incisions, one at the distal wrist crease and a second one on the mid-palm, 2.5cm from the first incision. Through these two incisions, the proximal and distal extent of the transverse carpal ligament (TCL) was identified and two specifically designed dissector-retractors were introduced. One to isolate the deep surface of the TCL protecting the median nerve and the other to isolate the superior surface of the ligament. The TCL was then divided under direct vision.
Results: One hundred and seventy-nine cases were studied from 1996 to 1999 with a minimum follow-up of three months. The patients were assessed using the scoring system described by Levine et al 1993. The overall improvement of symptoms was 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 included eight patients with pillar pain; one transient superficial palmar branch numbness; one transient digital branch paraesthesia; one retained suture and two superficial wound infections.
Conclusions: This new technique appears to have the potential benefits of small incision surgery such as endoscopic techniques. It uses simple and re-useable instruments, and has been shown to be safe.
The abstracts were prepared by Professor Alan Thurston. Correspondence should be addressed to him at the New Zealand Orthopaedic Association, PO Box 7451, Wellington, New Zealand.
