AUTHOR=Zhou Qiaoyin , Shen Yifeng , Zhu Xinyue , Sun Xiaojie , Qiu Zuyun , Li Shiliang , Zhang Weiguang 

TITLE=Ultrasound-guided percutaneous release procedures in the transverse carpal ligament by acupotomy: A cadaveric study

JOURNAL=Frontiers in Surgery

VOLUME=9

YEAR=2023

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.906109

DOI=10.3389/fsurg.2022.906109

ISSN=2296-875X

ABSTRACT=<sec><title>Objective</title><p>This study aimed to determine the safety and accuracy of ultrasound-guided acupotomy percutaneous loosening of the transverse carpal ligament.</p></sec><sec><title>Methods</title><p>The 100 upper limb specimens were equally divided into the ultrasound-guided acupotomy group (<italic>U</italic>) and the nonultrasound-guided acupotomy group (<italic>N</italic>). For the <italic>U</italic> group, we simulated ultrasound-guided acupotomy loosening of the transverse carpal ligament in a human specimen, and for the <italic>N</italic> group, we performed the loosening of the transverse carpal ligament through the same approach under nonultrasound-guided conditions. The safety and accuracy of the two methods were compared through measurement.</p></sec><sec><title>Results</title><p>In the ultrasound-guided group, the injury rate of nerves, blood vessels and tendons caused by needle-knife release was 0%. In the non-ultrasound-guided group, the rate of nerve, blood vessel and tendon damage was 6 percent, 12 percent and 20 percent, respectively. <italic>χ</italic><sup>2</sup> test (Fisher exact test) was performed for the nerve and blood vessel damage rates in the two groups (<italic>P<sub>N</sub></italic> &gt; 0.05, <italic>P<sub>A</sub></italic> &lt; 0.05), the difference in nerve damage rates was not statistically significant, but the difference in blood vessel damage rates was statistically significant. Pearson's <italic>χ</italic><sup>2</sup> test was performed on the tendon injury rates of the two groups (<italic>P<sub>F</sub></italic> &lt; 0.05), and the difference was statistically significant. In the ultrasound-guided group, the proportion of acupotomy marks greater than or equal to half of the width of the transverse carpal ligament was 86%, and the non-ultrasound-guided group was 36%. The accuracy of the two surgical methods was tested by Pearson's <italic>χ</italic><sup>2</sup> test (<italic>P<sub>L</sub></italic> &lt; 0.05), and the difference was statistically significant. According to the measurement, the ultrasound-guided acupotomy technology had high safety and accuracy.</p></sec><sec><title>Conclusion</title><p>In this study, we designed a new method for cutting the transverse carpal ligament under ultrasound guidance, which is different from surgery. These results indicate that this is a safe and accurate method of interventional treatment of carpal tunnel syndrome.</p></sec>