A new tool for mini-open carpal tunnel release - the PSU retractor.
BACKGROUND
Mini-open carpal tunnel release has become increasingly popular for the treatment of carpal tunnel surgery. The main advantages are shortening recovery time and return-to-work time. However, the risk of neurovascular injury still remains worrisome.


METHODS
In this study, we developed a new retractor (herein called the PSU retractor) modified from the widely used Senn retractor, with the aim of decreasing the risk of neurovascular problems from normal procedure. 3-Dimensional computer design software (SolidWorks Office Premium 2007 SP3.1) was used to construct a 3-D PSU retractor prototype. An amputated arm from a 30-year-old woman diagnosed as synovial sarcoma at the shoulder was used to test the maximal visual length. A mini-surgical incision was performed at 3 cm distal to the transverse wrist crease and a tiny flexible ruler was inserted through the tunnel beneath the skin to measure the maximal visual length.


RESULTS
Our new retractor showed significantly better maximal visual length compared to the Senn retractor (47.7(8.1) mm vs. 39.2(6.5) mm). In addition, most assessors expressed a higher satisfaction rate with the PSU retractor than with the Senn retractor (7.3 (1.9) vs. 6.3 (1.1)).


CONCLUSIONS
In conclusion, we have developed a promising new retractor using a computer design program, which appears to be an improvement on the currently available equipment used for mini-open carpal tunnel surgery. However, further clinical studies are needed to confirm our initial findings.
Wongsiri
Sunton
S
Department of Orthopaedic Surgery and Physical Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand. joesunton@yahoo.com
Suwanno
Porames
P
Tangtrakulwanich
Boonsin
B
Yuenyongviwat
Varah
V
Wongsiri
Ekkarin
E
D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery; D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D020342:Finite Element Analysis; D006801:Humans; D019637:Orthopedic Procedures / Q000295:instrumentation* / Q000379:methods*; D013584:Sarcoma, Synovial / Q000601:surgery; D013525:Surgical Instruments