Internal Neurolysis as an Adjunct to the Treatment of the Carpal-Tunnel Syndrome

In a series of ninety-six operations for carpal-tunnel syndrome, internal neurolysis of the median nerve was done under loupe magnification after division of the transverse carpal ligament. This combined procedure increased the success of the operation in a group of patients with constant sensory loss or thenar muscle atrophy, or both, or palsy, restoring both sensation and motor power to the denervated part of the hand, so that less than 10 per cent of the patients did not have good results. Internal neurolysis may not be indicated in patients with transient symptoms of numbness with no thenar atrophy since simple division of the transverse carpal ligament gives a high percentage of good results.