An open twin incision technique of carpal tunnel decompression with reduced incidence of scar tenderness.

We retrospectively compared a single curved incision for carpal tunnel decompression (group A, 29 wrists in 26 patients) with a twin incision technique (group B, 34 wrists in 30 patients), leaving an intact bridge of skin at the base of the palm. Patients in group B reported statistically significant subjective improvement in the early post-operative period, with fewer residual symptoms and earlier recovery of function compared to patients in group A. After a mean post-operative period of 23 months, 5/29 wrists were symptomatic in group A compared to 1/34 wrists in group B at 13 months, but this was not statistically significant. The twin incision technique is easy to perform and allows rapid post-operative recovery. The incidence of scar tenderness is reduced as palmar cutaneous branches of the median nerve are avoided. Because the distal portion of the transverse carpal ligament is divided under direct vision, this technique is not associated with any significant neurovascular complications.