REVIEWS   

Minerva Ortopedica e Traumatologica 2009 April;60(2):119-27

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Revision carpal tunnel surgery

Duncan S. F. M., Kakinoki R

Mayo Health System, Owatonna, MN, USA

Revision carpal tunnel surgery essentially falls into three categories. The first category includes those patients who fail primary carpal tunnel release and require a second surgery. The second category of patients includes those people who represent true recurrence, i.e., those whose symptoms improved initially, but recur at some later point in time. The third category includes those patients who have sustained nerve injury at the index procedure. Care needs to be taken that any postoperative complaints are not related to concomitant neurologic, vascular, tendon, or carpal joint issues. Besides a thorough neurologic exam of the hand, upper extremity and neck, one should take the time to evaluate the musculotendinous units, joint units, and vascular system. Techniques that can be used to try and address the three types of revision include microneurolysis, flap coverage of neuroma in situ, nerve grafting, and other flap types.