Carpal and Cubital Tunnel Release
(For median and ulnar nerve entrapment)

Carpal tunnel syndrome (CTS) is the most common malady affecting the hand. The basic underlying cause is pressure on the median nerve as it passes through the carpal tunnel at the wrist. Once pain begins, the condition gradually worsens and may result in permanent nerve damage. It is common for CTS to occur in both hands.

Anatomy

• The carpal tunnel is formed by eight carpal bones in a U-shape on the posterior (back) aspect of the wrist and the transverse carpal ligament (also referred to as the flexor retinaculum) bridging across the carpal bones on the anterior (front) aspect of the wrist (Figure 1)
  
• Through the 'tunnel' formed by the bones and ligament pass the tendons that allow the fingers to flex and the median nerve
  
• The median nerve is responsible for conducting sensations such as pain from the thumb and first two fingers, and the adjacent palm of the hand. The nerve also controls some muscles that move the thumb

Figure 1 - Anatomy of structures passing through the carpal tunnel including the median nerve and flexor tendons. © T. Graves	Figure 2 - Sensory distribution of the median and ulnar nerves. © T. Graves