Review Question - QID 210154

A 55-year-old female presents with persistent right palm, thumb, index, and long finger paresthesias with associated weakness. She reports a carpal tunnel released 1 year ago with no change in her preoperative symptoms. She reports no nighttime symptoms at any point but reports trouble using a key and volar proximal forearm pain. Figure A and B shows her hand clinically and radiographically. On physical exam you note normal 2-point discrimination in all digits with weakness of FPL, FDP to the index, and FCR. She has a negative CMC grind test. Figure C shows radiographs of her elbow. Elbow exam is normal other than pain with palpation of the lacertus fibrosis and a positive Tinel's test over the medial antecubital fossa. Following failure of appropriate nonoperative measure, which of the following is the next best step in treatment?