title: Ultrasound-guided carpal tunnel release using the manos CTR system.
abstract: OBJECTIVE
  Ultrasound (US) has been used in the management of carpal tunnel syndrome since the 1980s. The first report of US-guided carpal tunnel release (CTR) was published in 1997, with cadaver and clinical reports confirming the safe navigation of surgical tools with US for division of the transverse carpal ligament. The MANOS CTR device was recently reported as a minimally invasive tool for CTR, and may be well suited for use with US guidance.
  
  
  METHODS
  The authors report three cases of US-guided CTR using the MANOS CTR device. The MANOS device was inserted in a blunt configuration into the safe zone, and the cutting surface was deployed with a thumb-activated trigger that simultaneously ejected a sharp through the palm. The transverse carpal ligament was divided safely and confirmed with US.
  
  
  RESULTS
  US allowed for clear identification of the median nerve, safe zones, transverse carpal ligament, and the MANOS CTR device in relation to all pertinent structures of the carpal tunnel. Complete division of the transverse carpal ligament was confirmed in all three cases. There were no median nerve, vessel, tendon injuries, or chronic regional pain syndrome in any of the three cases.
  
  
  CONCLUSIONS
  US-guided CTR with the MANOS CTR device appears to be a safe technique and successful in confirming complete release.
authors: Department of Plastic Surgery, California Pacific Medical Center, San Francisco, CA, USA.
authors: Gregory
authors: G
authors: Buncke
authors: Bruce
authors: B
authors: McCormack
authors: Marko
authors: M
authors: Bodor
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008022:Ligaments / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000295:instrumentation* / Q000379:methods; D058971:Tenotomy / Q000379:methods*; D018084:Ultrasonography, Interventional