Abstract:

Objective   To report the palmar approach and surgical method for the view to provide anatomical data for the volar single-aperture approach of endoscopic carpal tunnel release(ECTR).  Methods 16 specimens of fresh adult upper limb were used to observe and measure the anatomical structures in the carpal tunnel and palm. 6 specimens of fresh adult upper limb were used randomly to simulate the operation that divided the flexor retinaculum and released the median nerve of ECTR by one-point technique in palm. Results   The best entrance point in palm of ECTR: Draw a parallel line along the thumb in the maximal abduction position to the ulnar side, and draw a axis between the middle finger and the ring finger; Mark the intersection of the lines, and then take an incision in the ulnar aspect about 1cm away from the intersection. Surgical plane was the lacunar space between the superficial fascia and palmar aponeursis.   Conclusion   Our study confirms that ECTR by one-point technique in palm is safe and feasible. It’s practical for surgeons to adopt the surgical approach of  ECTR and avoid damage  during severance offlexor retinaculum and relief of the median nerve under endoscope.

Key words: The entrance point in palm, Minimally invasive treatment, Carpal tunnel syndrome, Anatomical studies