Carpal tunnel syndrome. Video of the surgical technique.

Abstract

Introduction

A common form of compression of the median nerve (MN) is carpal tunnel syndrome. Its occurs when the MN is compressed at the wrist by the anterior annular ligament. It is the cause of dysesthesias and paresthesias in the hand, in the cutaneous territory innervated by the MN. In case of lack of treatment, these symptoms can be complicated by anesthesia, as well as motor deficit and atrophy of the thenar region, affecting the opposition of the thumb. Treatment can be conservative or surgical. Among the latter we find endoscopic techniques and open release. The objective of the video is to describe the open release surgical technique of the MN at the level of the carpal tunnel.

Materials and methods

A 77-year-old man presented paresthesia and pain in the right thenar region of 3 years of evolution. An electromyogram was performed showing a moderate degree of involvement of the right MN in the carpal tunnel. The patient had positive Tinel, Durkan and Phalen signs. It was decided to resolve him surgically since the conservative treatment failed.

Results

Open NM decompression was performed at the level of the carpal tunnel, without complications. The patient presented improvement in pain and paresthesia, being discharged from the hospital on postoperative day 1. Symptomatic remission was evidenced in post-operative controls.

Conclusion

We have described the surgical technique of open decompression of the MN at the level of the carpal tunnel. The procedure was successful and the patient presented symptomatic remission after surgery.