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CC BY-NC 4.0 · Arch Plast Surg 2015; 42(03): 327-333
DOI: 10.5999/aps.2015.42.3.327
Original Article

Surgical Treatment of Carpal Tunnel Syndrome through a Minimal Incision on the Distal Wrist Crease: An Anatomical and Clinical Study

Authors

  • Hye Mi Yoo

    Department of Plastic and Reconstructive Surgery, Institute of Health Sciences, GNUH Gyeongsang National University School of Medicine, Jinju, Korea

  • Kyoung Suk Lee

    Department of Plastic and Reconstructive Surgery, Institute of Health Sciences, GNUH Gyeongsang National University School of Medicine, Jinju, Korea

  • Jun Sik Kim

    Department of Plastic and Reconstructive Surgery, Institute of Health Sciences, GNUH Gyeongsang National University School of Medicine, Jinju, Korea

  • Nam Gyun Kim

    Department of Plastic and Reconstructive Surgery, Institute of Health Sciences, GNUH Gyeongsang National University School of Medicine, Jinju, Korea
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Background An anatomical analysis of the transverse carpal ligament (TCL) and the surrounding structures might help in identifying effective measures to minimize complications. Here, we present a surgical technique based on an anatomical study that was successfully applied in clinical settings.

Methods Using 13 hands from 8 formalin-fixed cadavers, we measured the TCL length and thickness, correlation between the distal wrist crease and the proximal end of the TCL, and distance between the distal end of the TCL and the palmar arch; the TCL cross sections and the thickest parts were also examined. Clinically, fasciotomy was performed on the relevant parts of 15 hands from 13 patients by making a minimally invasive incision on the distal wrist crease. Postoperatively, a two-point discrimination check was conducted in which the sensations of the first, second, and third fingertips and the palmar cutaneous branch injuries were monitored (average duration, 7 months).

Results In the 13 cadaveric hands, the distal wrist crease and the proximal end of the TCL were placed in the same location. The average length of the TCL and the distance from the distal TCL to the superficial palmar arch were 35.30±2.59 mm and 9.50±2.13 mm, respectively. The thickest part of the TCL was a region 25 mm distal to the distal wrist crease (average thickness, 4.00±0.57 mm). The 13 surgeries performed in the clinical settings yielded satisfactory results.

Conclusions This peri-TCL anatomical study confirmed the safety of fasciotomy with a minimally invasive incision of the distal wrist crease. The clinical application of the technique indicated that the minimally invasive incision of the distal wrist crease was efficacious in the treatment of the carpal tunnel syndrome.

Keywords

Carpal tunnel syndrome - Median nerve - Anatomy - Wrist - Cadaver

This article was presented as a poster at the 73th Congress of Korean Society of Plastic and Reconstructive Surgeons on November 7-9, 2014 in Seoul, Korea




Publication History

Received: 12 December 2014

Accepted: 25 February 2015

Article published online:
05 May 2022

© 2015. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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