CARPAL TUNNEL SYNDROME
In case of carpal tunnel syndrome the surgical treatment consists in the resection of the transverse carpal ligament, which relieves the subjective complaints. If the syndrome has been in an advance stage with atrophy of the muscles innervated by the median nerve, these atrophies are just a little improved. The skin incision is made along the path of the transverse creases of the wrist, reaching the ligament which is dissected under the skin and is divided completely. The skin incision can be done also longitudinally with slight curve in the 'S', coinciding with the skin creases in the wrist (Figs. 21-29; 21-30). The evident atrophy of the hand muscles, innervated by the median nerve is an indication for dissection of the motor branch of the median nerve. This branch usually separates immediately after the exit of the nerve from the carpal tunnel. The same branch may be compressed if it passes through the separate foramen in the transverse ligament at that place.
