My Orthopaedic Surgeon

Mini-open carpal tunnel release using Senn retractor has been increasingly popular for treatment of carpal tunnel surgery. The main advantages are shortening the recovery and return-to-work time. However, the risk of neurovascular injury still remains worrisome.
In this study, we developed a new retractor (herein called the PSU retractor) modified from the widely used Senn retractor, with the aim of decreasing the risk of neurovascular problems from this procedure.
Sunton Wongsiri , Porames Suwanno , Boonsin Tangtrakulwanich , Varah Yuenyongviwat and Ekkarin Wongsiri BMC Musculoskeletal Disorders 2008, 9:126 Full text available

Carpal tunnel syndrome is a common complaint seen in orthopaedic clinics. Surgical therapy involves release of the flexor retinaculum, a procedure well tolerated by patients under a local anaesthetic (1). The median nerve is at risk of iatrogenic damage during the procedure due to its close relation to the overlying ligament. So a bloodless field is preferable before any sharp dissection is performed near the nerve. To enable this it is common practice to perform the operation under tourniquet control. Use of the tourniquet often requires pressures on the arm of 250mmHg or more that can be very uncomfortable for the conscious patient. Our preferred technique for carpal tunnel release enables the procedure to be performed swiftly and safely thus minimising tourniquet time and patient discomfort.
R Samuel Clinical Research Fellow R Samarji Consultant Orthopaedic Surgeon Dept of Orthopaedics, Manchester Royal Infirmary, Manchester, UK.