Minimally invasive thread carpal tunnel release (TCTR) is a puncture-like technique designed to minimize injury and soft tissue dissection. This procedure uses a thread to release the transverse carpal ligament, typically performed under local anaesthesia.
Carpal tunnel syndrome is a prevalent condition characterized by tingling, pain, and numbness in the hand and arm due to compression of the median nerve. Conservative management includes activity modification and bracing to optimize wrist positioning and prevent excessive flexion. If these measures are unsuccessful, surgical intervention or less invasive treatments, such as minimally invasive thread carpal tunnel release (TCTR), may be considered to facilitate faster functional recovery and improved cosmetic outcomes.
Ultrasound imaging is employed to identify the median nerve at the wrist and to determine appropriate entry and exit points for needle placement. Under ultrasound guidance, a Tuohy needle is inserted, and a cutting thread is passed through it. The objective is to create a loop around the transverse carpal ligament without making incisions. Under direct visualisation, Dr Freed pulls the threads to divide the ligament. The procedure typically lasts 10 to 15 minutes, though the duration may vary depending on individual circumstances.
After the procedure, a small adhesive dressing is applied to cover the needle entry sites. The dressing is generally removed after 24 hours; however, patients should follow Dr Freed’s specific instructions.
Minimally invasive thread carpal tunnel release (TCTR) is considered an innovative technique that alleviates the symptoms of carpal tunnel syndrome and offers several advantages, including:
It is important to note that this procedure may not be appropriate for all patients and requires thorough assessment. As with any medical intervention, there are associated risks. Dr Freed will provide a detailed explanation of the procedure, including its benefits and risks, during the consultation to ensure patient understanding and confidence.
Rooms: Life Wilgeheuwel Hospital, Amplifier Street, Radiokop Ext 13, Roodepoort
Tel: (0)11 794 8629
E-mail: hands24wilg@gmail.com
The orthopaedic surgeon, Dr Neil M Freed, is fellowship-trained. This means that the doctor qualified first as a specialist in orthopaedic surgery and thereafter spent time at an academic institution doing just hand surgery to obtain his fellowship in that subspecialty. He has been practising hand surgery exclusively since 1992.
