Wednesday, February 7, 2007

Minimally Invasive Carpal Tunnel Decompression Using the Knife Light

(Neurosurgery. 2007 Feb;60(ONS1):162-169)

Abstract: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17297379&query_hl=9&itool=pubmed_docsum

24 comments:

Coordinator said...

These authors report the outcomes in 44 patients who had carpal tunnel release using a $60 illuminated carpal tunnel "tome" via a 1cm incision at the distal wrist crease. There were no complications and outcomes were excellent, with an early return to work and hand discomfort for only about 2 weeks. These results are in agreement with previous controlled studies using this device.

In essence, the difference between this technique and older carpal tunnel "tomes" is the light, which can help confirm general tip location, which becomes brighter as it passes the distal margin of the transverse carpal ligament. This helps avoid "over-shooting" the distal edge, which may occur when one traditionally confirms the ligament is cut by palpation of the distal tome through the palm, or by moving it past the distal margin to make certain it is cut, which may lead to palmar arch injury.

It would have been nice to see a better illustration (image or video) of the light changing quality as the ligament is released. Also, does the light only shine from the lower edge of the tool, which remains below the ligament until it is released? Overall, besides the "blind" aspect, this technique appears to be an improvement over previous tomes, and economical as well.

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