Our technique, in essence, is an extension of the commonly performed blind carpal tunnel steroid injection, and has the advantages of safety, accuracy of medication placement, effectiveness, noninvasiveness, ease of performance, and lower cost than open surgical release
. To current blind injection, our technique adds direct visual guidance under ultrasound, actual separation of the median nerve from the compressing flexor retinaculum throughout the carpal tunnel by hydrodissection, and mechanical partial disruption of the retinaculum to decrease wall tension-generated compression on the nerve.
Longitudinal incision in surgical release
of De Quervain disease.
Three methods for treating trigger finger in children are observation, serial extension splinting, and surgical release
of the A1 pulley.
If this fails to respond to therapy, surgical release
is indicated prior to opponensplasty.
(2) The research on patients with trigger finger indicates various methods of treating patients including splinting, nonsteroidal anti-inflammatory agents, percutaneous injection of corticosteroids, and surgical release
. (1,5,6) Several of the aforementioned treatments are invasive and involve risk of radial digital nerve injury, tenolysis, infection and persistence.
In 41 of these patients, manipulation successfully released the joint, and in the remaining 25, open surgical release
was required (J.
Conventional CTS treatments include simple hand splinting; steroid injection into the carpel tunnel, which has marginal long-term efficacy; and surgical release
of the impinging ligament.
Treatment of compartment syndrome is surgical release
of the fascia.
The patient was graded as stage 4 A according to Andrade classification and planned for surgical release
of fibrotic bands and inferiorly based melolabial flap reconstruction bilaterally under general anaesthesia.
It is important to note that the thumb radial digital nerve crosses over the A1 pulley at the level of the surgical release
and must be identified and protected.