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Incising
Skin and Palmer Aponeurosis
- After tourniquet exsanguination of the
upper extremity, use a #15 blade
to incise the palmar skin, coursing through
skin and subcutaneous fatty
tissue exposing the palmar aponeurosis (Figure
3)
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Incising Distal Portion
of Transverse Carpal Ligament
- Incise the palmar aponeurosis exposing
the transverse carpal ligament at its distal
portion. Care should be taken not to damage
the vascular arch.’s line) in the palm.
- Use either a self-retaining retractor
or two Senn retractors transversely and
one Ragnell retractor proximally, to expose
the distal portion of the transverse carpal
ligament which is
then identified (Figure 4)
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