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. 2008 Sep 22:9:126.
doi: 10.1186/1471-2474-9-126.

A new tool for mini-open carpal tunnel release - the PSU retractor

Sunton Wongsiri  1 , Porames Suwanno, Boonsin Tangtrakulwanich, Varah Yuenyongviwat, Ekkarin Wongsiri
Affiliations

A new tool for mini-open carpal tunnel release - the PSU retractor

Sunton Wongsiri et al. BMC Musculoskelet Disord. .

Abstract

Background: Mini-open carpal tunnel release has become increasingly popular for the treatment of carpal tunnel surgery. The main advantages are shortening recovery time and return-to-work time. However, the risk of neurovascular injury still remains worrisome.

Methods: In this study, we developed a new retractor (herein called the PSU retractor) modified from the widely used Senn retractor, with the aim of decreasing the risk of neurovascular problems from normal procedure. 3-Dimensional computer design software (SolidWorks Office Premium 2007 SP3.1) was used to construct a 3-D PSU retractor prototype. An amputated arm from a 30-year-old woman diagnosed as synovial sarcoma at the shoulder was used to test the maximal visual length. A mini-surgical incision was performed at 3 cm distal to the transverse wrist crease and a tiny flexible ruler was inserted through the tunnel beneath the skin to measure the maximal visual length.

Results: Our new retractor showed significantly better maximal visual length compared to the Senn retractor (47.7(8.1) mm vs. 39.2(6.5) mm). In addition, most assessors expressed a higher satisfaction rate with the PSU retractor than with the Senn retractor (7.3 (1.9) vs. 6.3 (1.1)).

Conclusion: In conclusion, we have developed a promising new retractor using a computer design program, which appears to be an improvement on the currently available equipment used for mini-open carpal tunnel surgery. However, further clinical studies are needed to confirm our initial findings.

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Figures

Figure 1
Figure 1
3D model of PSU retractor. 3D model of PSU retractor has created by SolidWorks program (A), (B).
Figure 2
Figure 2
Bilateral concave and taper blade of PSU retractor. PSU retractor (A) has bilateral concave (white arrow) and taper blade (black arrow) for aid insertion compared to Senn retractor (B).
Figure 3
Figure 3
Concave curve with bilateral wing of PSU retractor. Demonstrated concave curve (white arrow) at distal end with bilateral wing (black arrow) of PSU retractor to aid for watching and cutting transverse carpal ligament (A) as compared with Senn retractor (B).
Figure 4
Figure 4
Two sizes in blade of PSU retractor. Demonstrated two different sizes in blade of PSU retractor.
Figure 5
Figure 5
The maximum visual length. The maximum visual length was defined as the farest distance seen on scale of the ruler from the proximal edge of skin incision.
Figure 6
Figure 6
The graph of the yield strength and the ultimate strength of both Senn and PSU retractor. The yield strength and the ultimate strength of both Senn and PSU retractor were comparable from finite element analysis.
See this image and copyright information in PMC

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