Friday, September 14, 2007

Carpal tunnel release

ANATOMY
b/w hook of hamate and pisiform
Palmar cutaneous branch runs outside retinaculum on radial side

in 14% of cases the motor branch will course through the flexor retinaculum (transligamentous)

PROCEDURE
Incision on ulnar side of thenar crease from lower border of flexor retinaculum to proximal wrist crease

Find and protect palmar cutaneous branch of median nerve (located close to palmaris longus, FCR, FPL and on thenar side of median nerve

Incise palmar fascia

Divide retinaculum close to hamate on ulnar side to protect the motor branch

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