Introduction: The surgical management for carpal tunnel syndrome is the release of pressure on the median nerve by dividing the transverse carpal ligament. There are different ways to release median nerve viz.extensive lazy ‘S’ incision from palm to forearm and the advanced arthroscopic release at wrist. We describe a simple, effective and minimally invasive surgery for C.T.S. to divide transverse carpal ligament.

Material & method: We present 38cases of C.T.S. after clinical and Electro diagnosis confirmation underwent the minimal invasive surgery. A 1” transverse incision over the center of distal wrist crease placed exposing the palmeris longus (retracted/divided) and exposing transverse carpal ligament. These transverse fibers are cut in the line of skin incision and exposing the median nerve. With blunt curved scissors the transverse ligament is cut distally in the palm and proximally in the wrist separating from the median nerve thus relieving the compression. The wound is closed in layers over the drain and compression bandage applied. Post operatively hand elevated for 24hours, drain removed after 48hours and suture removed at 7th day.

Results: In all the 38cases there was pain relief immediately after the surgery. There was progressive neurological recovery (sensory/motor) took place from 6months to 1year. One case developed a pulsatile swelling at the wrist (false A-V aneurysm). The false aneurysm was due to accidental nicking of superficial palmar branch of radial artery, which was ligated on second day. There was superficial marginal necrosis was observed in 6 cases, which healed in 12–16 days.

Discussion: The technique is simple, short, safe, economic, effective and easily reproducible. The transverse incision gives better visualization of transverse carpal ligament; easy resection of the ligament and better exposion of median nerve at the wrist makes this procedure to have good results. This tiny incision is in the langhans line at wrist has early wound healing, a cosmetic scar and least morbidity.

Introduction: Fractures of the forearm bones are not uncommon and every orthopedic surgeon has his share in treating these cases. The general consensus in the treatment of fractures of both bones forearm in adults is operative and there are various modes of internal fixations available, the choice of which rests on the treating surgeon. No matter what the implants are used the goal is to obtain sound union with excellent functional outcome and early mobilization. The aim of this paper is to demonstrate the combination of ulnar nailing and radial plating in the management of fractures both bones of forearm.

Materials and method: We are presenting our series of 237patients with fractures of both bones forearm during the period 1995 to 2000 treated ulna with Talwarkar’s square nail and radius -AO narrow DCP. Under G.A / brachial block first retrograde ulnar nailing with minimal exposure and minimal periosteal stripping followed by radial plating through Thompson’s approach… We followed a uniform operating technique and the post-operative protocol of A. E.pop slab/cast for 4 weeks and functional cast for next 4 weeks and radiological review after 3,12 months The implants are removed at average of 15 months

Result: 98.2% cases had bony union in our series, 2 cases had ulna hypertrophy non-union, 2 delayed union, which were managed with immobilization in cast for 3 months. There was nail breakage in 2 cases due to fall, olecranon bursa in 10 due to irritation by the nail and superficial infection in 7 cases was managed with antibiotics.The fixation with ulna nailing and radial plating has average operating time of 35 minutes. We have removed implants from 125 cases after bony union.

Conclusion: There is a recent emphasis on the concept of undreamed solid nailing, which preserves the biology enhances fractures healing and reduces wound infection.

The reduced operation time, economic implant, least periosteal stripping, least blood loss and subsequent easy implant removal are the advantage of this procedure.