[Treatment of carpal tunnel syndrome with mini-incision decompression].

OBJECTIVE

To introduce the method of the transverse carpal ligament (TCL) transection through palmar mini-incision for carpal tunnel syndrome (CTS) and evaluate its efficacy and safety.

METHODS

From January 2006 to September 2007, 15 patients (18 hands) with CTS were treated with palmar longitudinal mini-incision decompression. There were 2 males and 13 females, with an average age of 48 years (ranged 34 to 69) and an average course of 18 months (ranged 8 to 26). The main clinical symptom including the radial numbness or pain of the 3 and a half fingers, wrist pain and radiation to the forearm, the night awake history of numbness, thenar muscle atrophy, positive Tinel sign and Phalen sign. Median nerve electrophysiology showed that sensory nerve conduction velocity (SCV) slowed down and sensory nerve action potential (SNAP) decreased or missed, short abductor muscle of thumb had spontaneous potential in severe cases. Clinical effect were evaluated according to the Global symptom score (GSS) scoring in aspect of pain, numbness, paraesthesia, weakness and nocturnal awakening.

RESULTS

Postoperative wound smoothly healed in all patients and no complications occurred. All patients were followed up from 20 to 28 months with an average of 24 months. Symptoms of 1 patient had not incomplete relief, other patient's symptoms disappeared and muscle force of abductor pollicis brevis reinforced. Postoperative GSS scoring obviously improved than preoperative (P < 0.05).

CONCLUSION

Treatment of carpal tunnel syndrome through palmar mini-incision decompression has advantages such as higher safe, shorter operative time, less invasive, smaller scar, which can cut off carpi transversum ligament and thoroughly decompress median nerve under direct sight, it is a safe and effective operative approach.