Ultrasound‐Guided Incisionless Carpal Tunnel Release Using a Hook Knife: A Cadaveric Study
Bibliographic record
Abstract
BACKGROUND: Carpal tunnel syndrome (CTS) is the most common entrapment mononeuropathy of the median nerve. In comparison to open surgical and endoscopic carpal tunnel release, a new ultrasound-guided hook knife carpal tunnel release (CTR) procedure was reported to have superior results in terms of reduced morbidity and early return to work. OBJECTIVE: To evaluate the reproducibility of the hook knife CTR procedure when performed by musculoskeletal ultrasound trained physicians without prior experience in this technique. DESIGN: Cadaveric study. SETTING: Tertiary-level academic institute. PARTICIPANTS: Sixteen lightly embalmed forearm and hand specimens. METHODS: The ultrasound-guided CTR was done using a 1-mm proximal wrist puncture, creation of a tunnel, followed by the retrograde percutaneous release of the transverse carpal ligament (TCL) using a 3-mm hook knife. MAIN OUTCOME MEASUREMENTS: Assessment of the completeness of TCL release, the integrity of the surrounding neurovascular structures, and the technical and subjective procedural difficulty encountered during the procedure. RESULTS: In 14 of 16 specimens, complete release of the TCL was achieved. In two specimens with an incomplete release, the TCL resection was 52% and 55%, respectively. The integrity of the surrounding neurovascular structures and superficial anatomy volar to the dissection path was maintained in all specimens. The mean level of procedural difficulty was 2.6 (range 2-4) on a Likert 5-point rating scale. CONCLUSIONS: In cadavers, the ultrasound-guided hook knife CTR procedure was found to be reproducible when performed by ultrasound-trained physicians with no experience in this technique. Further in vivo investigations are required.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".