Opponensplasty by the Palmaris Longus Tendon to the Rerouted Extensor Pollicis Brevis Transfer With Endoscopic Carpal Tunnel Release in Severe Carpal Tunnel Syndrome

2021 ◽  
Author(s):  
Akihiro Hirakawa ◽  
Shingo Komura ◽  
Marie Nohara ◽  
Tomihiro Masuda ◽  
Yasuharu Matsushita ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Longus Tendon ◽  
Extensor Pollicis Brevis ◽  
Palmaris Longus ◽  
Endoscopic Carpal Tunnel Release ◽  
Tunnel Syndrome ◽  
Palmaris Longus Tendon

scholarly journals The Palmaris Longus and Its Association with Carpal Tunnel Syndrome

2020 ◽  
Vol 9 (06) ◽  
pp. 493-497
Author(s):  
Andrew D. Boltuch ◽  
Michael A. Marcotte ◽  
Christopher M. Treat ◽  
Anthony L. Marcotte
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Carpal Tunnel ◽  
Predictive Value ◽  
Carpal Tunnel Release ◽  
Longus Tendon ◽  
Palmaris Longus ◽  
Tunnel Syndrome ◽  
Palmaris Longus Tendon

Abstract Background The palmaris tendon inserts into the palmar fascia and is positioned in close association with the transverse carpal ligament. Loading of this tendon has been demonstrated to increase carpal tunnel pressures. Purpose The purpose of this study was to determine if a relationship exists between the palmaris tendon, carpal tunnel syndrome (CTS), and handedness. The sensitivity, specificity, positive predictive value, and negative predictive value for Schaeffer's test were calculated. Methods A retrospective review of patient charts undergoing endoscopic carpal tunnel release was performed. Rates of palmaris longus agenesis (PLA) were compared to a population matched data set. Statistical analysis was performed using a one-proportion z-test. Schaeffer's test for the palmaris longus tendon was performed on all patients and compared to intraoperative confirmation. Results A total of 520 carpal tunnel releases were performed in 389 consecutive patients. The frequency of PLA in this surgical cohort was significantly lower compared to the population matched dataset. No correlation between handedness and laterality of CTS or PLA was found. Schaeffer's test was evaluated to yield sensitivity (93.6%), specificity (100%), positive predictive value (100%), and negative predictive value (50.8%). Conclusion The palmaris tendon was more prevalent in a population of patients undergoing carpal tunnel release. These findings can be used to provide further insight into the pathophysiology of CTS. While Schaeffer's test was accurate in detecting the palmaris longus tendon, a negative test was frequently incorrect. Further imaging is recommended in patients with a negative Schaeffer's test when the palmaris longus is desired for surgical utilization. Level of Evidence This is a Level III, prognostic study.

Palmaris profundus in the carpal tunnel

2021 ◽  
Vol 14 (8) ◽  
pp. e241328
Author(s):  
Theodore Paul Pezas ◽  
Rajive Jose
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Anatomical Variant ◽  
Longus Tendon ◽  
Raising Awareness ◽  
Tunnel Syndrome ◽  
Palmaris Longus Tendon ◽  
Secondary Causes

Carpal tunnel release is a routinely performed operation to relieve pressure caused by compression on the median nerve. In the majority of cases, the causation of the compression will be idiopathic. Among the secondary causes of median nerve compression is the palmaris profundus, a rare anatomical variant separate to the palmaris longus tendon. It has been suggested that it may cause carpal tunnel syndrome as it courses underneath the flexor retinaculum with the contents of the carpal tunnel reducing the space available to the median nerve. Several cases have found it intimately associated with the median nerve within the carpal tunnel. Raising awareness of this anatomical variant is therefore important for those undertaking carpal tunnel decompression in order to avoid unintended damage.

The Clinical Significance of the Palmaris Longus Tendon in the Pathophysiology of Carpal Tunnel Syndrome

2006 ◽  
Vol 31 (6) ◽  
pp. 657-660 ◽  
Author(s):  
G. R. KEESE ◽  
M. D. WONGWORAWAT ◽  
G. FRYKMAN
Keyword(s):  
Risk Factor ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Independent Risk Factor ◽  
Prospective Clinical Study ◽  
Absolute Increase ◽  
Longus Tendon ◽  
Palmaris Longus ◽  
Tunnel Syndrome ◽  
Palmaris Longus Tendon

Carpal tunnel syndrome is associated with increased intracarpal canal pressure. The effect of tendon loading on intracarpal canal pressures is documented in biomechanical studies. Palmaris longus loading in wrist extension induces the greatest absolute increase in intracarpal canal pressure. Despite this fact, the palmaris longus is not yet a proven independent risk factor for the development of carpal tunnel syndrome. The purpose of this prospective clinical study was to assess and quantify the association between the presence of a palmaris longus tendon and carpal tunnel syndrome. Thirty-six carpal tunnel subjects with bilateral disease were compared with 36 controls. Each subject was clinically examined for the presence of the palmaris longus tendon. The prevalence of palmaris longus agenesis was significantly lower in the carpal tunnel group. The palmaris longus tendon is a strong independent risk factor for carpal tunnel syndrome.

The Safest Location for Steroid Injection in the Treatment of Carpal Tunnel Syndrome

2005 ◽  
Vol 30 (4) ◽  
pp. 412-414 ◽  
Author(s):  
O. RACASAN ◽  
TH. DUBERT
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Steroid Injection ◽  
Major Complication ◽  
Longus Tendon ◽  
Palmaris Longus ◽  
Flexor Carpi Ulnaris ◽  
Tunnel Syndrome ◽  
Palmaris Longus Tendon

Steroid injections are routinely performed for carpal tunnel syndrome. Direct needle injury of the median nerve is the major complication of these injections. The safest location of the injection remains controversial. The purpose of this study is to define safe guidelines to avoid nerve injury. The distances between the Median nerve, Palmaris Longus, Flexor Carpi Ulnaris and Flexor Carpi Radialis tendons were measured preoperatively, 1 cm proximal to the distal wrist crease in 93 endoscopic carpal tunnel releases. We found that the median nerve extended ulnarly beyond the Palmaris Longus tendon in 82 hands (88%). It is concluded that the median nerve is at risk if the injection is performed within 1 cm on either the ulnar or radial side of the Palmaris Longus tendon. More ulnarly, there is risk to the ulnar pedicle. The safest location is to inject through the FCR tendon.

scholarly journals Anomalous Palmaris Longus Tendon Causing Carpal Tunnel Syndrome

2019 ◽  
Vol 52 (03) ◽  
pp. 360-361
Author(s):  
Harsh R. Shah ◽  
Amita Hiremath ◽  
Mukund R. Thatte
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Longus Tendon ◽  
Palmaris Longus ◽  
Tunnel Syndrome ◽  
Palmaris Longus Tendon

Carpal Tunnel Syndrome Accompanying Radial Dysplasia Due to Thalidomide Embryopathy

2006 ◽  
Vol 31 (3) ◽  
pp. 342-344 ◽  
Author(s):  
Y. OSHIMA ◽  
I. OKUTSU ◽  
I. HAMANAKA ◽  
T. MOTOMURA
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Pressure Measurements ◽  
Endoscopic Carpal Tunnel Release ◽  
Sensory Disturbances ◽  
Tingling Sensation ◽  
Tunnel Syndrome

We performed endoscopic carpal tunnel release in four hands in three patients suffering from radial dysplasia due to thalidomide embryopathy. Carpal canal pressure measurements results confirmed the diagnoses. All operations were successfully performed and resulted in no complications. Tingling sensation and sensory disturbances of the hands subsided.

ENDOSCOPIC CARPAL TUNNEL RELEASE FOR RECURRENT CARPAL TUNNEL SYNDROME AFTER PREVIOUS OPEN RELEASE

Hand Surgery ◽  
2004 ◽  
Vol 09 (02) ◽  
pp. 235-239 ◽  
Author(s):  
Lam Chuan Teoh ◽  
Puay Ling Tan
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Open Release ◽  
Endoscopic Carpal Tunnel Release ◽  
Endoscopic Release ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release ◽  
Surgical Release

Recurrent carpal tunnel syndrome from various causes has been shown to occur in up to 19% of patients. Endoscopic carpal tunnel release has been used to decompress the median nerve in carpal tunnel syndrome for many years. However, endoscopic release for recurrent carpal tunnel syndrome after previous surgical release has not been reported. Nine hands in six patients had recurrent carpal tunnel syndrome five to 20 years after previous open carpal tunnel release. All the cases were successfully treated with endoscopic release.

Persistent or recurrent carpal tunnel syndrome following prior endoscopic carpal tunnel release

1998 ◽  
Vol 23 (6) ◽  
pp. 1010-1014 ◽  
Author(s):  
Douglas L. Forman ◽  
H. Kirk ◽  
Kathryn A. Caulfield ◽  
James Shenko ◽  
Andrew E. Caputo ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Endoscopic Carpal Tunnel Release ◽  
Tunnel Syndrome
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