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A Journal on Surgery

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Chirurgia 2006 October;19(5):349-52

language: Italian

Use of hyaluronic acid in the surgery of the carpal tunnel to prevent pillar pain. Evaluation clinical-instrumental with follow-up of three months. Preliminary study on 36 patients

Monacelli G. 1, 2, Spagnoli A. M. 2, Rizzo M. I. 2, Valesini L. 2, Pardi M. 2, Parlanti S. 3, Irace S. 2

1 Neuromed IRCCS Pozzilli Isernia
2 S. S. Chirurgia Plastica Ricostruttiva Urg. DEA Policlinico Umberto I Università degli Studi di Roma ''La Sapienza'', Roma
3 Dipartimento di Radiologia DEA Policlinico Umberto I Università degli Studi di Roma ''La Sapienza'', Roma


Aim. Open carpal tunnel release was performed in 36 hands (36 patients) using a 2,5 cm palmar incision. After release of the median nerve at carpal canal, in half patients associated application of 1 ml of hyaluronic acid.
Methods. The patients were assessed at regular intervals after surgery for hand functions and subjective symptoms, in particular pillar pain.
Results. There was rapid wound recovery with minimal post-operative pain and scarring, and return to functional activities, within four weeks. At an average follow-up of 90 days, 91% of patients had complete or significant resolution of hand paraesthesia. No patient required further surgery. However, pillar pain was found in 50% of hands at four weeks in patients hyaluronic acid negative (H–). At the end of follow-up all patients treated with hyaluronic acid (H+) had complete resolution, 24% of patients no treated with hyaluronic acid mantain pain.
Conclusion. The significance of the incidence of pillar pain is discussed.

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