Ann Rehabil Med.  2023 Feb;47(1):19-25. 10.5535/arm.22130.

Cadaveric Study of Thread Carpal Tunnel Release Using Newly Developed Thread, With a Histologic Perspective

• Park HY
• Kim JM
• Kim IJ
• Kang M
• Ham JR
• Nam YS

• KMID: 2539724
• DOI: http://doi.org/10.5535/arm.22130

Abstract

Objective
To examine the usefulness and feasibility of modified thread carpal tunnel release (TCTR) by comparing the results of using pre-existing commercial thread with those of a newly developed thread (Smartwire-01).
Methods
A total of 17 cadaveric wrists were used in the study. The modified TCTR method was practiced by two different experts. Pre-existing commercial surgical dissecting thread (Loop&Shear^TM) was used for five wrists and the newly developed Smartwire-01 was used for twelve wrists. The gross and microanatomy of the specimens were evaluated by a blinded anatomist.
Results
Both types of thread were able to cut the TCL similarly. Gross anatomy and histologic findings showed that there was no significant difference between the two types of threads. However, the practitioners felt that it was easier to cut the TCL using the newly-developed thread.
Conclusion
TCTR using Smartwire-01 was as effective as pre-existing Loop&Shear^TM, with better user experiences.

Keyword

Carpal tunnel syndrome; Median neuropathy; Cadaver; Ultrasonography; Interventional ultrasound

Figure

• 

  Fig. 1. Gross images of (A) Loop&ShearTM (Ridge & Crest Company, Monterey Park, CA, USA) and (B) Smartwire-01 (Smart Wire Co., Ltd., Ilsan, Korea).

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  Fig. 2. Gross findings of transverse carpal tunnel transection after modified thread carpal tunnel release. The red arrowheads indicate the transected transverse carpal ligament. (A) Dissection with Loop&ShearTM (Ridge & Crest Company, Monterey Park, CA, USA). (B) Dissection with Smartwire-01 (Smart Wire Co., Ltd., Ilsan, Korea).

• 

  Fig. 3. Histologic findings of the transverse carpal ligament (Masson’s trichrome stain, ×75). The black arrowheads indicate the transected transverse carpal ligament. (A) Dissection with Loop&ShearTM (Ridge & Crest Company, Monterey Park, CA, USA). (B) Dissection with Smartwire-01 (Smart Wire Co., Ltd., Ilsan, Korea).

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  Fig. 4. Visualization of the two threads on ultrasound. The red arrowheads indicate the looped thread surrounding the transverse carpal ligament. (A) Dissection with Loop&ShearTM (Ridge & Crest Company, Monterey Park, CA, USA). (B) Dissection with Smartwire-01 (Smart Wire Co., Ltd., Ilsan, Korea).

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  Fig. 5. Dissected transverse carpal ligament shown on ultrasound. The red arrowheads indicate the transected transverse carpal ligament in the short-axis view. (A) Dissection with Loop&ShearTM (Ridge & Crest Company, Monterey Park, CA, USA). (B) Dissection with Smartwire-01 (Smart Wire Co., Ltd., Ilsan, Korea).

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