Newly Developed Operative Instrument for Carpal Tunnel Release: A Cadaveric Study

Objective: This study aims to assess the effectiveness and safety of the newly designed instruments, Carpal tunnel release (CTR) Knives 2 and 3, which use a limited skin incision technique in cadavers. Materials and Methods: The study utilized 36 wrists from 18 fresh cadavers for CTR Knife 22 and 24 wrists from 12 fresh cadavers for CTR Knife 3. None of the cadavers had a history of previous injury or surgical interventions. A limited longitudinal palmar incision was made for the carpal tunnel release, conducted with the newly developed CTR Knives, which are equipped with a disposable blade number 15 (for CTR Knife 2) or 11 (for CTR Knife 3). To assess the completeness of transverse carpal ligament (TCL) transection, the skin incision was extended proximally to expose and evaluate the released ligament. Meticulous dissection was performed to identify any potential injuries to the neurovascular structures around the surgical area. Results: CTR Knife 2 achieved a complete cut of TCL for 35 of 36 cadaveric wrists, with only one incomplete cut, while CTR Knife 3 achieved 21 out of 24 complete TCL cuts. The incomplete cuts were likely due to severe thickening of the ligament. Subsequent exploration after the procedure revealed no identifiable injury to the neurovascular structures or tendons in the surrounding area. Conclusion: The newly developed CTR Knives 2 and 3 effectively transected the TCL without causing injury to surrounding structures and preserved, the overlying fascial coverage of the ligament.