Mini-transverse Incision using Swivel Knife for Treatment of Carpal Tunnel Syndrome: An innovative Idea and Preliminary Report "Amin’s technique"

Abstract

Background: Carpal tunnel syndrome [CTS] is the commonest entrapment neuropathy of the upper limb. Different treatment modalities [conservative and surgical] are present. Each has its advantages and disadvantages. No consensus is found about the ideal surgical treatment modality. Aim of the work: To introduce an innovative use of swivel knife with mini-transverse incision in median nerve release. Also to compare the study results' to the conventional approach. Patients and methods: Seventy patients included in the study. All had confirmed diagnosis of CTS and scheduled for surgical treatment. The new technique using theSwivel Knife has operated on 35 patients [study group] and the traditional technique was done for 35 patients [control group]. All patients have been assessed clinically and by neuro-physiological studies [preoperatively, and at 3 months postoperatively]. Both groups were compared regarding patient demographics and all preoperative data. Results: Significant postoperative findings were superior in the study group. Results in the study group showed a reduction of operative time, incision length, Levine score and pain score at 3 months [0.23±0.43 vs 0.89±1.21 respectively, p < 0.05]. In addition, study group was associated with higher safety and patient satisfaction. Conclusion: Introduction of swivel knife with mini-transverse incision just proximal to distal wrist crease is an effective and safe. This technique could be promising alternative option for surgical treatment of CTS.

Keywords

• swivel knife
• mini-transverse
• median nerve
• carpal tunnel syndrome
• neurophysiological