Treatment for Carpal Tunnel Syndrome by Coronal Z-type Lengthening of the Transverse Carpal Ligament

Objective: to compare the effects of coronal z-type lengthening of transverse carpal ligament with conventional open approach for carpal tunnel syndrome. methods: a double-blinded study was conducted from january 2005 to august 2008 on 68 patients with a mean age of 41 years (range 27~55 years) diagnosed as severe carpal tunnel syndrome. they were randomized into two groups(a and b). patients in group a underwent coronal z-type lengthening of transverse carpal ligament, and patients in group b had conventional open approach surgery. postoperative evaluation was scheduled at 1, 3, 6 and 12 months after the surgery and incidence rate of bowstring of the flexor tendons, improvement of grip strength and adl activities of daily living) score were recorded. results: fifty-eight patients had been followed up successfully, 30 and 28 for group a and b respectively. the scar tissue formation of the flexor tendons in group b was observed more than that in group a at 6 and 12 month after operation. improvement of grip strength were observed in two groups, which was statistically different between 6 and 12 months after operation and no significant difference was seen between 1 and 3 months after operation. according to adl, the satisfaction rates documented on form for patients were statistically different in the two groups at 6 and 12 months after operation and no difference was noted at 1 and 3 months after operation. conclusion: excellent improvement of function and satisfaction were achieved by coronal z-type reconstruction of the flexor retinaculum for severe carpal tunnel syndrome. our method offers a more effective alternative method for conventional carpal tunnel open decompression surgery.