Open Carpal Tunnel Surgery Through a Mini-Palmar Skin Incision

Carpal tunnel syndrome (CTS) is a relatively common entrapment syndrome encountered in neurosurgical practice. In this syndrome, the median nerve is entrapped under the transverse carpal ligament at the wrist. This syndrome is characterized by nocturnal pain in the wrist, dysesthesia, motor loss, and, rarely, muscle atrophy. Many techniques have been used for carpal tunnel surgery; besides the classical incision, minimally invasive and endoscopic techniques have been defined in recent years. Five hundred cases (590 hands) operated for CTS in our clinic over an 9-year period were reviewed retrospectively, and the mini-incision technique involving an incision of 1 cm length was described. Of the 500 cases, 405 patients (81%) were female and 95 (19%) were male, and 90 (18%) cases were operated on for bilateral CTS. Intraoperatively, no vascular complications leading to neuronal or tendon damage have been encountered; reoperation was not recorded, except 1 patient operated on again 3 months after the first operation because of fibrosis. The mini-incision technique, in comparison with the long classical incision technique, minimizes the disadvantages of a prolonged healing process, pillar pain, scar tenderness, and cosmetic problems such as scar sensitivity; in contrast, it has the advantages of not requiring technical equipment, allowing direct observation of the median nerve compartment with a low complication rate, and also being an alternative method to endoscopic techniques, which has more transient nerve problems.