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  • Publicado : 19 de enero de 2011
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Table of Contents
Indications/Contraindications . . . . . . . . . . . . . . . .i Warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .i Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Surgical Setup . . . . . . . . . . . . . . . . . . . . . . . . . . .2-4 Anesthesia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4Operative Technique Step 1 Step 2 Step 3 Step 4 Step 5 Step 6 Step 7 Step 8 Step 9 Making the incision and creating a flap. . . . . . . . . . . . . . . 5-6 Elevating the U-shaped flap. . . . . . . . . 7 Preparing a path . . . . . . . . . . . . . . . . . . 8 Introducing the instrument . . . . . . . 9-10 Defining the distal margin of the ligament . . . . . . . . . . . . . . . . . . 11 Incising thetransverse carpal ligament . . . . . . . . . . . . . . . 12-15 Inspecting the incised ligament . . . . . . . . . . . . . . 16-17 Releasing the forearm fascia . . . . . . . 18 Closing and dressing the wound and wrist. . . . . . . . . . . . . . . . . . . . . . . 18

Troubleshooting Guide for Fogging . . . . . . . . . .19 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19 Indications/Contraindications
• The MicroAire Carpal Tunnel Release System is indicated for patients diagnosed with carpal tunnel syndrome that is not associated with, nor secondary to, any other known pathology (i.e., idiopathic carpal tunnel syndrome). Patients with known abnormalities of the wrist affecting the carpal tunnel, including distal radius and wrist deformities, rheumatoid, or otherdiseases of the synovium, have not been studied and are contraindicated. Patients with congenital anatomical abnormalities, particularly those with abnormalities of the hook of the hamate, are contraindicated. Patients with smaller hands or an unusually tight carpal tunnel are contraindicated. • Preoperative X-rays of the wrist, including a carpal tunnel view, are strongly recommended to aid in thediagnosis of associated pathology such as calcific tendonitis and fracture of the hook of the hamate. • This device is indicated solely for releasing the transverse carpal ligament.

Warnings
• The surgeon is specifically advised not to use the instrument to explore and/or treat any structure other than the transverse carpal ligament within, or outside of, the carpal tunnel. Failure to heed thiswarning can lead to damage to the median or ulnar nerve, flexor tendons or superficial palmar arterial arch. • If the surgeon is unable to clearly visualize an ulnar “strip” of the transverse carpal ligament with a definite distal margin (which is typically characterized by a transition from ligament to fat), the blade assembly should be withdrawn and the procedure should be converted to aconventional open carpal tunnel release. • If the surgeon has any questions or concerns regarding patient anatomy, the surgical approach or instrument function—or if the view is less than adequate— the instrument should be withdrawn and the procedure converted to an open carpal tunnel release. • Failure to follow the proper training and surgical technique can result in permanent injury to the patient.Endoscopic release of the carpal tunnel using the MicroAire Carpal Tunnel Release System should not be attempted until the surgeon has been trained at a MicroAire-sponsored workshop or approved training. This training requires becoming thoroughly familiar with this Surgical Technique, the User’s Guide and gaining hands-on experience with a trained surgeon who is experienced with the device. Theprocedure should be performed on cadaveric specimens before initial use. Operating room staff should thoroughly review the MicroAire Carpal Tunnel Release System User’s Guide prior to set up of this system.

i

Introduction
Traditionally, a patient treated surgically for carpal tunnel syndrome could expect significant recovery time away from work due to the surgical wound in the palm and heel of...
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