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Journal of Hand Surgery (British and European Volume)
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Articles

Risk of Neurovascular Injury with Limited-Open Carpal Tunnel Release: Defining the "Safe-Zone"

T. L. ATIK
B. SMITH
M. E. BARATZ

From the Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA

Correspondence: Dr Mark E Baratz, Department of Orthopaedic Surgery, Allegheny Professional Building, 490 East North Avenue, Suite 500, Pittsburgh, PA 15212-4740, USA. E-mail: mbaratz{at}wpahs.org

Limited-open carpal tunnel release was performed in ten cadaver arms using the "Safeguard" system. The "Safeguard" guide was intentionally placed off of the longitudinal middle/ring finger axis, either in 15° of radial deviation or 15° of ulnar deviation. Despite the errant placement, carpal tunnel release was performed without damage to any neurovascular structure. The proximity of neurovascular structures to the middle/ring finger axis was measured in all ten cadaver specimens. From this, a "safe-zone" was defined for endoscopic or limited-open carpal tunnel release. The "safe-zone" expands when surgery is performed from distal to proximal. The area of the "safe-zone" is greatest when a protective guide is placed between the bursal sac of the carpal canal and the flexor retinaculum.

Journal of Hand Surgery (British and European Volume), Vol. 26, No. 5, 484-487 (2001)
DOI: 10.1054/jhsb.2001.0583
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