Minimally invasive approaches dominate latest carpal tunnel
In 2017, hand surgeons have a variety of techniques to achieve what should be the goals of every type of treatment for patients with carpal tunnel syndrome: decompress the median nerve within the carpal tunnel, allow better movement of or release the transverse carpal ligament, reduce pain and restore wrist function.

Orthopaedics Today Europe spoke with international experts about newer treatments for carpal tunnel syndrome (CTS) that are in clinical or experimental use worldwide or just now being researched. They agreed ultrasound guidance is being used more regularly during the part of CTS surgery performed to section the transverse carpal ligament (TCL). It is also reportedly being used to more effectively diagnose CTS and guide injection of steroids to treat it or manage the pain associated with CTS.

Sources said some novel methods to section the TCL and different surgical devices are among the newer CTS treatment options, including a forward-facing knife for endoscopic releases. However, they cautioned that the evidence available about the effectiveness and safety of some of these newer methods is often weak and, in some instances, nonexistent. Furthermore, they said meta-analyses of CTS studies are hard to do because CTS presents differently in every patient. Severity may depend on the patient’s occupation, whether he or she is healthy, or has diabetes and other factors.

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