Endoscopic release of distal holdfast fibers of the flexor retinaculum for carpal tunnel syndrome / 中国微创外科杂志

ABSTRACT

Objective To investigate the necessity of releasing the distal holdfast fibers of the flexor retinaculum(DHFFR) during endoscopic carpal tunnel release(ECTR).Methods The Experiment Group included 16 cases.The operation was conducted under brachial plexus anesthesia without the use of tourniquet.A 1 cm skin incision was made.The USE system(Universal Subcutaneous Endoscope System) was employed.Both flexor retinaculum(FR) and distal holdfast fibers of the flexor retinaculum were cut off.Postoperative outcomes were compared with another 16 cases of flexor retinaculum release only(Control Group).Results Follow-up evaluation was carried out at 6 postoperative months.According to the Kelly's criteria,there were 13 cases of excellent results and 3 cases of good results in the Experiment Group,and 8 cases of excellent,5 cases of good,and 3 cases of fair results in the Control Group.Significant difference was obser red in flameda Ⅱ or Ⅲ grade patients between the two groups in carative effects(?~2=6.278,P=0.043).No serious complications or postoperative recurrence occurred.Conclusions Flexor retinaculum is not the only structure existing in the carpal canal to be released.More attention should be paid to complete decompression of both flexor retinaculum and distal holdfast fibers of the flexor retinaculum,especially in those who have serious symptoms.