Carpal Tunnel Repair and Fasciectomy for Carpal Tunnel Syndrome and Dupuytren’s Disease

1. Introduction

2. Tourniquet

3. Incision in Thenar Crease

4. Incision through Palmar Aponeurosis

5. Clearing Tissue Superficial to Transverse Carpal Ligament (TCL) and Creating Space to the Distal Forearm

6. Gently Starting Incision Through TCL with Scalpel

7. Proximal TLC Release into Distal Forearm with Dissecting Scissors

8. Distal TLC Release with Scalpel and Dissecting Scissors

9. Closure

10. Incision

11. Skin Flaps

12. Identification of Neurovascular Bundles and Diseased Fascia

13. Dissection Around Retrovascular Cord and Partial Excision

14. Complete Excision of Remaining Cord

15. Addressing Tissue Towards Ring Finger

16. Releasing Tourniquet and Checking Circulation

17. Hemostasis

18. Reapplying Tourniquet and Closure

19. Local Anesthetic 

20. Drain Placement and Dressing for Splinting