Houston Methodist. Leading Medicine

Hand FAQ

Question:

I saw somebody yesterday with a tiny scar across the wrist from carpal tunnel surgery. When I had my carpal tunnel release the incision was much longer and up and down on my palm. How come such a difference for the same operation?

Answer:

Carpal tunnel release has come a long way in a short time. Many surgeons have moved away from the long, open incision to an endoscopic approach. In this method, a special tool is inserted underneath the skin. The operation is done using special imaging that allows the surgeon to see what's going on.

A second new method is the limited-open method. A vertical incision is still made in the palm. This allows the surgeon to see the entire retinaculum, which is cut. The retinaculum is a fibrous band of tissue across the carpal tunnel. Cutting the retinaculum takes the pressure off the median nerve.

The tiny sideways cut you saw is from the mini-open technique. A large enough opening is made to let the surgeon see the edge of the retinaculum. Then a special knifelight is used to cut the rest. Studies are being done to find out which method is best.

Paolo Cellocco, MD, et al. Mini-Open Blind Procedure Versus Limited Open Technique for Carpal Tunnel Release: A 30-Month Follow-Up Study. In The Journal of Hand Surgery. May 2005. Vol. 30A. No. 3. Pp. 493-499.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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