Single-Portal Endoscopic Carpal Tunnel Release Compared with Open Release by Thomas E. Trumble, Edward Diao, Reid A. Abrams, and Mary M. Gilbert- Anderson.

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Single-Portal Endoscopic Carpal Tunnel Release Compared with Open Release by Thomas E. Trumble, Edward Diao, Reid A. Abrams, and Mary M. Gilbert- Anderson J Bone Joint Surg Am Volume 84(7): July 1, 2002 ©2002 by The Journal of Bone and Joint Surgery, Inc.

Scar sensitivity was measured with use of a plunger with a 1.0-cm2 base to apply a 3.0-kg-force pressure to three locations: the distal wrist crease, the midpart of the carpal tunnel, and the distal part of the carpal tunnel. Thomas E. Trumble et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

For the open release, the incision is made 2 mm ulnar to the thenar crease, just distal to the Kaplan oblique line (a line drawn from the apex of the interdigital fold between the thumb and index finger, toward the ulnar side of the hand and parallel with t... Thomas E. Trumble et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

A synovial elevator is used to reflect the synovial tissue from the undersurface of the transverse carpal ligament. Thomas E. Trumble et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

The Agee device is inserted into the carpal canal until the distal end of the ligament is visualized. Thomas E. Trumble et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

A Ragnell retractor is used to protect the skin edge as the Agee device is withdrawn during the release of the transverse carpal ligament. Thomas E. Trumble et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.

This intraoperative photograph demonstrates the intact soft tissues that include the palmar fascia and the palmaris brevis muscle (A) and the cut edge of the ligament (B) (top view) as well as the median nerve (C) (bottom view), which is immediately adjacen... Thomas E. Trumble et al. J Bone Joint Surg Am 2002;84: ©2002 by The Journal of Bone and Joint Surgery, Inc.