This is an old revision of the document!
Table of Contents
Operative Reports
Hand
Carpal Tunel Release
Operative Pearls Anatomy
Technical Steps
Will do Lalonde approach in clinic. Only change is to include epi in the local instead of a tourniquet.
1. Inject local
2. Prep and place tourniquet sterilly on forarm if in OR.
3. Rolled blue towels under wrist.
4. Mark approximately 2 cm incision and incise with 15 blade.
5. Go through subcuatneous tissue with 15 blade.
6. Dissect with Ragnell scissors. She will retract with 2 Ragnells and a sharp Sen.
7. Once TCL exposed, sharply incise with beaver blade or 15 blade.
8. Go distally until you reach the distal fat.
9. Incise proximally with beaver blade or 15 blade and then spread above and below with ragnell scissors (not to wide as you only need a tunnel for your scissors). This is so you can ensure the next step is done under direct vision.
10. Slide ragnell scissors proximally. This is a translation of the scissor. The scissor tips are curved and the tip goes straight proximally while your hand is off to the side and you translate it forward.
11. Ensure complete release with the freer.
12. Close with 4-0 nylon. She prefers locked horizontal mattress sutures.
Postoperative Care
Soft dressing
APAP/Ibuprofen
No Narcotics