title: Carpal tunnel release using the Paine retinaculotome inserted through a palmar incision.
abstract: BACKGROUND
  Carpal tunnel syndrome (CTS) is the most commonly diagnosed and treated entrapment neuropathy. There is no consensus regarding the optimal technique for carpal tunnel release. The objective of this study is to demonstrate the surgical treatment of CTS by a small palmar incision and utilization of Paine retinaculotome to divide the transverse carpal ligament.
  
  
  METHODS
  In this technical note, we describe the use of a retinaculotome described by Paine in 1955, through a palmar approach.
  
  
  CONCLUSIONS
  Open, minimally invasive and endoscopic surgical techniques have all been described as treatment options for CTS, and short-term success with these methods is well established. During the last decade, less invasive techniques have been developed in order to reduce the incidence of pillar pain and tender scars. We have used a mini-palmar incision and the Paine retinaculotome for carpal tunnel release since 1994. The goals of surgery are to create a small incision that permits a patient to have early motion and return to activity.
  
  
  CONCLUSIONS
  After many years, no permanent nerve or vascular damage has been reported. This method has demonstrated itself to be efficient and safe in the treatment of the carpal tunnel syndrome.
authors.affiliation: Hand Surgery Group, Department of Orthopedic Surgery, Universidade Federal de São Paulo, Rua Borges Lagoa 1065, cj 68/69, Sao Paulo, Sao Paulo CEP 04038-032 Brazil.
authors.forename: Carlos Henrique
authors.initials: CH
authors.lastname: Fernandes
authors.affiliation: Hand Surgery Group, Department of Orthopedic Surgery, Universidade Federal de São Paulo, Rua Borges Lagoa 1065, cj 68/69, Sao Paulo, Sao Paulo CEP 04038-032 Brazil.
authors.forename: Luis Renato
authors.initials: LR
authors.lastname: Nakachima
authors.affiliation: Hand Surgery Group, Department of Orthopedic Surgery, Universidade Federal de São Paulo, Rua Borges Lagoa 1065, cj 68/69, Sao Paulo, Sao Paulo CEP 04038-032 Brazil.
authors.forename: Celso Kiyoshi
authors.initials: CK
authors.lastname: Hirakawa
authors.affiliation: Hand Surgery Group, Department of Orthopedic Surgery, Universidade Federal de São Paulo, Rua Borges Lagoa 1065, cj 68/69, Sao Paulo, Sao Paulo CEP 04038-032 Brazil.
authors.forename: João Batista
authors.initials: JB
authors.lastname: Gomes Dos Santos
authors.affiliation: Hand Surgery Group, Department of Orthopedic Surgery, Universidade Federal de São Paulo, Rua Borges Lagoa 1065, cj 68/69, Sao Paulo, Sao Paulo CEP 04038-032 Brazil.
authors.forename: Flavio
authors.initials: F
authors.lastname: Faloppa
keywords: Carpal tunnel syndrome; Median neuropathy; Paine retinaculotome; Palmar approach