13-Year Experience of Carpal Tunnel Release Using the Indiana Tome Technique

W. P.Andrew Lee, Bret M. Schipper, Robert J. Goitz

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: This study evaluated the reliability and morbidity rate of carpal tunnel release with the Indiana Tome technique via a small palmar incision when used by experienced hand surgeons. Methods: A retrospective review was performed of 1332 carpal tunnel releases using the Indiana Tome performed by 2 fellowship-trained hand surgeons at university hospitals from July 1993 to August 2006. Chart review focused on complications with this technique. Results: All patients returned to preoperative activities, in employment or otherwise. Nonmanual laborers resumed regular job tasks between 2 days and 3 weeks. The 2 surgeons experienced 11 complications in 1332 cases, for an overall complication rate of 0.83%. The most common complication, in 8 cases, was numbness and hypersensitivity in the third common digital nerve distribution; 2 of these 8 patients had normal 2-point discrimination and the other 6 had persistently 2-point discrimination greater than 10 mm despite resolution of preoperative paresthesia symptoms. In the latter group, 3 patients had repeat exploration, with findings of fascicular injury and scarring in 2 patients and normal nerve in the third (who ultimately had normalized 2-point discrimination by 6 weeks after surgery). The 3 patients without re-exploration had their 2-point discrimination returned to normal by 11 months after surgery. Ultimately, only 2 patients (0.15%) had persistently increased 2-point discrimination. The remaining complications (3 cases) were transient neuropraxia of the entire median nerve (1 patient), an incomplete release (1 patient) requiring repeat surgery, and a recurrence of carpal tunnel syndrome (1 patient) with perineural scar noted at 8 months after surgery, treated successfully with a hypothenar fat pad flap. Conclusions: This is the largest retrospective review of the Indiana Tome technique to date. This technique can be used by experienced hand surgeons and offers early resumption of preoperative activities and a low complication rate. The most common complication was neurapraxia in the third common digital nerve distribution. The overall complication rate was 0.83% (11 in 1332). Type of study/level of evidence: Therapeutic IV.

Original languageEnglish (US)
Pages (from-to)1052-1056
Number of pages5
JournalJournal of Hand Surgery
Volume33
Issue number7
DOIs
StatePublished - Sep 1 2008
Externally publishedYes

Fingerprint

Wrist
Hand
Cicatrix
Carpal Tunnel Syndrome
Hypesthesia
Paresthesia
Median Nerve
Reoperation
Adipose Tissue
Hypersensitivity
Morbidity
Recurrence
Surgeons
Wounds and Injuries

Keywords

  • Carpal tunnel release
  • carpal tunnel syndrome
  • Indiana Tome

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

13-Year Experience of Carpal Tunnel Release Using the Indiana Tome Technique. / Lee, W. P.Andrew; Schipper, Bret M.; Goitz, Robert J.

In: Journal of Hand Surgery, Vol. 33, No. 7, 01.09.2008, p. 1052-1056.

Research output: Contribution to journalArticle

Lee, W. P.Andrew ; Schipper, Bret M. ; Goitz, Robert J. / 13-Year Experience of Carpal Tunnel Release Using the Indiana Tome Technique. In: Journal of Hand Surgery. 2008 ; Vol. 33, No. 7. pp. 1052-1056.
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