Arch Plast Surg.  2020 Nov;47(6):597-603. 10.5999/aps.2020.01732.

Open carpal release using local anesthesia without a tourniquet: Does bleeding tendency affect the outcome?

• Lee S
• Oh S
• Son D

• KMID: 2508837
• DOI: http://doi.org/10.5999/aps.2020.01732

Abstract

Background
The aim of this study was to analyze the clinical results of minimal single palmar-incision carpal tunnel release without a tourniquet.
Methods
We reviewed the medical records of 75 patients (90 cases of carpal tunnel syndrome) who underwent minimal single-palmar incision carpal tunnel release without a tourniquet from June 2010 to January 2018. Ten patients had a bleeding tendency. We compared the preoperative and postoperative Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) scores. We also analyzed outcomes and complications according to the presence of a bleeding tendency.
Results
In all cases, there was a complete disappearance or marked improvement in symptoms within 6 months, with no recurrence. The postoperative BCTQ score showed a significant improvement compared to the preoperative score, and no statistically significant difference in BCTQ scores was detected according to the presence of a bleeding tendency.
Conclusions
Carpal tunnel release without a tourniquet using a minimal single palmar incision is effective and reliable. This technique prevents unnecessary pain associated with the tourniquet and is especially helpful in patients with a bleeding tendency or those treated with hemodialysis.

Keyword

Carpal tunnel syndrome; Median nerve; Nerve compression syndrome; Hand; Tourniquet