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A Clinical Study of the Improvement of Thread Carpal Tunnel Release
Danzhu Guo, MD; Danqing Guo, MD
BayCare Clinic, Green Bay, WI
Purpose: A previous study on 34 hands has revealed thread carpal tunnel release (TCTR) is a safe and effective. Through the study on 11 cadaveric wrists, TCTR had been improved with the needle control accuracy 0.15-0.2 mm to preserve superficial palmar aponeurosis ( SupPA ) , Berrettini branch and common digital nerves. The aim of present study was to verify the improved TCTR clinically.
Methods: The improved TCTR was performed on 112 hands of 80 patients. Boston Carpal Tunnel Syndrome Questionnaire was used for assessing the outcomes. Comparisons were conducted with the scores from the open and endoscopic techniques.
Results: The outcomes of TCTR patients revealed significant improvement in the short-term results, and slightly better in long-term results than that with the open or endoscopic release. The SupPA, Berrettini branch, and common digital nerves were protected. There was no neuromuscular complication for each case. Significant relief of symptoms were observed 3 to 5 hours post procedure. Most patients used their hands the day of the procedure for simple daily activity. Their sleep quality was improved on the surgical day. Most patients with office jobs were able to return to work postoperative day 1, and those with repetitive jobs returned to work in about two weeks.
Conclusion: TCTR has been improved to be a safe and effective technique for carpal tunnel release, through which the postoperative complications, such as pillar pain, scar tenderness, or functional weakness, might be minimized significantly by avoiding the unnecessary injuries to the surrounding of the TCL during the procedure. The advantages of the TCTR over the OCTR and ECTR are less invasive in surgery and more precise in controlling accuracy.
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