Abstract
BackgroundMini-open carpal tunnel release has become increasingly popular for the treatment of carpal tunnel surgery. The main advantages are shortening recovery time and return-to-work time. However, the risk of neurovascular injury still remains worrisome.MethodsIn this study, we developed a new retractor (herein called the PSU retractor) modified from the widely used Senn retractor, with the aim of decreasing the risk of neurovascular problems from normal procedure. 3-Dimensional computer design software (SolidWorks® Office Premium 2007 SP3.1) was used to construct a 3-D PSU retractor prototype. An amputated arm from a 30-year-old woman diagnosed as synovial sarcoma at the shoulder was used to test the maximal visual length. A mini-surgical incision was performed at 3 cm distal to the transverse wrist crease and a tiny flexible ruler was inserted through the tunnel beneath the skin to measure the maximal visual length.ResultsOur new retractor showed significantly better maximal visual length compared to the Senn retractor (47.7(8.1) mm vs. 39.2(6.5) mm). In addition, most assessors expressed a higher satisfaction rate with the PSU retractor than with the Senn retractor (7.3 (1.9) vs. 6.3 (1.1)).ConclusionIn conclusion, we have developed a promising new retractor using a computer design program, which appears to be an improvement on the currently available equipment used for mini-open carpal tunnel surgery. However, further clinical studies are needed to confirm our initial findings.
Highlights
Mini-open carpal tunnel release has become increasingly popular for the treatment of carpal tunnel surgery
We demonstrate the method we used to develop a new instrument for mini-open carpal tunnel release and show some preliminary results of using this new retractor, we call the PSU retractor
The main differences between the new PSU retractor and the Senn retractor are shown in Figures 2, 3 and 4
Summary
Mini-open carpal tunnel release has become increasingly popular for the treatment of carpal tunnel surgery. The main advantages are shortening recovery time and return-to-work time. Surgical treatment [1] normally involves cutting the transverse carpal ligament to reduce the carpal tunnel pressure. Open carpal tunnel release (OCTR) remains the accepted standard operation [2], but newer procedures include endoscopic or semiblind mini-incision techniques are being increasingly performed. Postoperative pain and late recovery are the main drawbacks to OCTR [3,4,5,6]. Mini-incision carpal tunnel release using various types of tool such as the Indiana Tome (Biomet, Warsaw, USA), the KnifeLight (Stryker Instruments, Kalamazoo, Michigan, USA) and the "Safeguard" system (KMI, Inc., San Diego, USA) have recently (page number not for citation purposes)
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