[Plastic surgical enlargement of the anterior annular carpal ligament in the treatment of carpal tunnel syndrome]. 1990

A I Kapandji
Clinique de l'Yvette, Longjumeau.

In the treatment of the carpal tunnel syndrome the simple division of the transverse carpal ligament sometimes causes a certain weakness of the grip strength, which takes a very long to recover. In order to avoid this inconvenience, a new technique is described consisting in an enlargement plasty of the transverse carpal ligament. The procedure is simple but precise: it consists in a zigzag incision making two flaps and suturing them over a gauge. It needs a great attention during the first stage not to accidentally wound the thenar branch of the median nerve. The division of the subcutaneous part of the ligament and the measuring of the enlargement is facilitated by a new instrument, the "Cat-Tongue Gauge" which is described there. If necessary, a pre-operative CT scan and another one performed three months later confirm the reconstruction of the ligament and the enlargement of the carpal tunnel. In 46 wrists, we observed no complications and rapid rehabilitation. Some rare painful scars can be avoided by a good location of the incision in the vertical hypothenar crease and by a precise dissection of the subcutaneous tissues. The strength of the grip seems to be recovered sooner than with the classical technique; a prospective study is started to confirm this point.

UI MeSH Term Description Entries
D008022 Ligaments Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. Interosseal Ligament,Interosseous Ligament,Interosseal Ligaments,Interosseous Ligaments,Ligament,Ligament, Interosseal,Ligament, Interosseous
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D002349 Carpal Tunnel Syndrome Entrapment of the MEDIAN NERVE in the carpal tunnel, which is formed by the flexor retinaculum and the CARPAL BONES. This syndrome may be associated with repetitive occupational trauma (CUMULATIVE TRAUMA DISORDERS); wrist injuries; AMYLOID NEUROPATHIES; rheumatoid arthritis (see ARTHRITIS, RHEUMATOID); ACROMEGALY; PREGNANCY; and other conditions. Symptoms include burning pain and paresthesias involving the ventral surface of the hand and fingers which may radiate proximally. Impairment of sensation in the distribution of the median nerve and thenar muscle atrophy may occur. (Joynt, Clinical Neurology, 1995, Ch51, p45) Compression Neuropathy, Carpal Tunnel,Entrapment Neuropathy, Carpal Tunnel,Amyotrophy, Thenar, Of Carpal Origin,Median Neuropathy, Carpal Tunnel,Carpal Tunnel Syndromes,Syndrome, Carpal Tunnel,Syndromes, Carpal Tunnel
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013518 Surgery, Plastic The branch of surgery concerned with restoration, reconstruction, or improvement of defective, damaged, or missing structures. Cosmetic Surgery,Esthetic Surgery,Plastic Surgery,Surgery, Cosmetic,Surgery, Esthetic,Reconstructive Surgery,Surgery, Reconstructive
D013524 Surgical Flaps Tongues of skin and subcutaneous tissue, sometimes including muscle, cut away from the underlying parts but often still attached at one end. They retain their own microvasculature which is also transferred to the new site. They are often used in plastic surgery for filling a defect in a neighboring region. Island Flap,Island Flaps,Flap, Surgical,Flaps, Surgical,Pedicled Flap,Surgical Flap,Flap, Island,Flap, Pedicled,Flaps, Island,Flaps, Pedicled,Pedicled Flaps
D013536 Suture Techniques Techniques for securing together the edges of a wound, with loops of thread or similar materials (SUTURES). Suture Technics,Suture Technic,Suture Technique,Technic, Suture,Technics, Suture,Technique, Suture,Techniques, Suture

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