Clinical Application of Turnover Lengthening of the Palmaris Longus Tendon in Modified Camitz Opponensplasty for Severe Carpal Tunnel Syndrome.

Abstract

Camitz opponensplasty performed for severe carpal tunnel syndrome (CTS) is sometimes complicated during the dissection of palmar aponeurosis, and it is difficult to obtain sufficient length and strength of the transition tendon. In this study, we modified the Camitz procedure and devised a tendon-lengthening approach that does not involve the palmar aponeurosis. We evaluated this procedure clinically. Our study included 11 patients with severe CTS and opposable thumb dysfunction. All patients underwent the same modified Camitz procedure including turnover lengthening of the palmaris longus (PL) tendon. Grip strength, pulp pinch, lateral pinch, active range of motion (thumb palmar abduction), and Quick Disability of the Arm, Shoulder, and Hand score were compared before and over 6 months after surgery. The mean follow-up duration was 15 months. No postoperative complications such as numbness, pain, or contracture of the thumb were observed. All parameters improved significantly (<i>P</i> < .05) after surgery. At the final follow-up, ultrasonography confirmed the presence and gliding of the transition tendon. Our modified method was effective in all cases, and a hemisected PL tendon seemed effective for opponensplasty for CTS.