Limited-open carpal tunnel release was performed in ten cadaveric specimens using the“Safeguard” system. This system consists of a knife and a guide with the release performed in a distal to proximal direction. Despite purposeful errant placement of the guide in either 15 degrees of radial deviation or 15 degrees of ulnar deviation, carpal tunnel release was performed without damage to neurovascular structures.
The authors conclude that the use of a protective cutting guide positioned between the bursal sac of the carpal canal and the flexor retinaculum may help to prevent iatrogenic injuries. They also propose that the “safe-zone” for retinacular release may increase when surgery is performed from a distal to proximal direction. Whether the procedure is done by an open, limited-open, or endoscopic technique, there is always risk of injury to tendons, nerves and vessels. A thorough understanding of normal and aberrant anatomy is paramount in avoiding complications.