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Sonographic assessment of transverse carpal ligament after open surgical release of the carpal tunnel.

OBJECTIVE
The aim of this study was to sonographically evaluate the anatomy of the transverse carpal ligament (TCL) after open surgical release in the treatment of carpal tunnel syndrome (CTS) and to establish new ultrasonographic criteria for the completeness of TCL release.


METHODS
Thirty-six patients who underwent open surgical release for CTS were recruited prospectively. Patients were evaluated with physical examination and ultrasonography before and after the operation.


RESULTS
All patients' symptoms resolved after surgery. TCL was found to be diffusely thickened and to have lost its smooth form after surgery. Postoperative TCL thickness showed a statistically significant increase when compared with preoperative values (p<0.05).


CONCLUSION
Sonography is a capable imaging method for assessment of the TCL after open release surgery. In addition, ultrasound may be considered as a complementary tool to exclude diagnosis of incomplete transection of TCL in patients with persistent symptoms.