Mini-palm open release technique (see text). A, Incision is marked with skin pen (only rarely is it necessary to extend the incision into the distal forearm). B, Exposure of transverse carpal ligament (TCL) with parallel palmar fascia fibers and hypothenar fat retraction. C, After division of TCL, distal 2.0 cm of antebrachial fascia is divided with Metzenbaum scissors. D, In this patient, median nerve is adherent to divided radial TCL leaf and was subsequently externally neurolyzed. E, Incision is closed and compressive dressing is applied (F to H). SEE TECHNIQUE 77.1.