Canaletto
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          Page 2/2   Carpal tunnel syndrome (2/2)
 
 
 

Before any surgical action is undertaken, the nerves of the hand must be examined by electromyography to test the conduction speeds of the median and ulnar nerves. When the nerve is compressed, these speeds change.
Surgery severs the flexor retinaculum so as to increase the size of the carpal tunnel, thus decompressing the median nerve.
Les chirurgiens disposent de plusieurs techniques pratiquées en ambulatoire. La méthode classique, dite à ciel ouvert. L'autre, plus récente, fait appel à l'endoscopie. Surgeons have several techniques at their disposal, used in out-patient services : the classical, so-called "open surgery" method ; another, more recent, technique, uses endoscopy. Complications may occur in all techniques ( lesion of a tendon, a nerve or a vessel).
Nowadays, the use of a flexor retinaculum reconstruction implant, the "Canaletto implant" opens up another possibility.
In a carpal tunnel open operation, having treated the syndrome using neurolysis and synovectomy, the surgeon then interposes and stitches an anatomically-shaped and sized implant between both edges of the flexor retinaculum, allowing reconstruction of the top end of the carpal tunnel.
This technique has many advantages and plays several roles :
- a protective role for the median nerve and the tendons
- a mechanical role, in that it ensures reconstruction of the retinaculum thanks to the stabilising bridge formed by the medial and lateral edges (the principle of the keystone in architecture)
- it acts as support for both subjacent and overlying healing
 

The advantages :
- recurrence no longer occurs,
- better quality healing, and, most important, less extensive bruising,
- sensory recovery is improved mainly among elderly patients or in severely compressed forms,
- considerably less pain,
- rapid recovery of strength,
- improved all-over comfort for the patient,
- everyday and professional activity can be resumed a few days after the operation.

 
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