Ultrasound-Guided Percutaneous Injection, Hydrodissection, and Fenestration for Carpal Tunnel Syndrome: Description of a New Technique

Ultrasound-Guided Percutaneous Injection, Hydrodissection, and Fenestration for Carpal Tunnel Syndrome: Description of a New Technique

Abstract

Objective: Carpal tunnel syndrome, caused by compression of the median nerve deep to the flexor retinaculum, is the most common entrapment neuropathy. Most patients are initially treated with conservative mea-sures such as splinting. When conservative measures fail, interventional techniques are considered the next step. Many studies have appeared comparing open surgical flexor retinaculum release to blind injections of corticosteroids into the carpal tunnel, but neither technique has proven superior to the other. Advantages of injection are: lower level of invasiveness, faster recovery, and ease of the technique. Occasional failures and complications occur with all techniques.

Conclusion: Ultrasound-guided hydrodis section and fenestration is a viable, easy, relatively non-invasive therapy for carpal tunnel syndrome that can result in pro longed symptom relief, and may be a way to postpone, or even obviate the need for, open release.

Abstract

Objective: Carpal tunnel syndrome, caused by compression of the median nerve deep to the flexor retinaculum, is the most common entrapment neuropathy. Most patients are initially treated with conservative mea-sures such as splinting. When conservative measures fail, interventional techniques are considered the next step. Many studies have appeared comparing open surgical flexor retinaculum release to blind injections of corticosteroids into the carpal tunnel, but neither technique has proven superior to the other. Advantages of injection are: lower level of invasiveness, faster recovery, and ease of the technique. Occasional failures and complications occur with all techniques.

Conclusion: Ultrasound-guided hydrodis section and fenestration is a viable, easy, relatively non-invasive therapy for carpal tunnel syndrome that can result in pro longed symptom relief, and may be a way to postpone, or even obviate the need for, open release.

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