Dynamic ultrasound for evaluating the adequacy of median nerve decompression following minimally invasive carpal tunnel release: technical innovation and case study

Chien-Hua Chen; Fu-Shan Jaw; Jia-Zhen Hu; Wei-Ting Wu; Ke-Vin Chang

doi:10.1016/j.heliyon.2023.e13107

Dynamic ultrasound for evaluating the adequacy of median nerve decompression following minimally invasive carpal tunnel release: technical innovation and case study

Heliyon. 2023 Jan 19;9(1):e13107. doi: 10.1016/j.heliyon.2023.e13107. eCollection 2023 Jan.

Authors

Chien-Hua Chen^{1

2}, Fu-Shan Jaw¹, Jia-Zhen Hu², Wei-Ting Wu^{3

4}, Ke-Vin Chang^{3

4

5}

Affiliations

¹ Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.
² Clive Chen Clinic, Taichung, Taiwan.
³ Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
⁴ Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan.
⁵ Center for Regional Anesthesia and Pain Medicine, Wang-Fang Hospital, Taipei Medical University, Taipei, Taiwan.

Abstract

Background: Minimally invasive carpal tunnel release has recently emerged as the primary surgical approach for recalcitrant carpal tunnel syndrome. A major concern related to surgical failure with this technique is the incomplete release of the flexor retinaculum.

Case presentation: We developed a technique using dynamic ultrasound for evaluating the adequacy of median nerve decompression following minimally invasive carpal tunnel release. This novel imaging method was applied to two patients who showed significant symptom relief after the intervention. This case study also provides details of the dynamic ultrasound protocol and highlights the advantages of this technique.

Conclusion: Dynamic ultrasound imaging can be used to confirm the completeness of carpal tunnel decompression. A large-scale prospective trial should be conducted to validate whether additional dynamic ultrasound examination can improve the outcome of minimally invasive carpal tunnel release.

Keywords: CTS, carpal tunnel syndrome; Carpal tunnel syndrome; Median nerve; Sonography; Surgery; Ultrasound.

Publication types

Case Reports