Poster 68: A Role for EMG in Carpal Tunnel Release Revision Surgery: A Case Report

PM&R ◽  
2009 ◽  
Vol 1 ◽  
pp. S133-S133
Author(s):  
Faguna Patel ◽  
Qiang G. Fang ◽  
John M. Ventrudo
Keyword(s):  
Case Report ◽  
Carpal Tunnel ◽  
Revision Surgery ◽  
Carpal Tunnel Release

scholarly journals Aberrant Positioning of the Ulnar Nerve Found During Carpal Tunnel Release: A Case Report

2019 ◽  
Author(s):  
David R. Veltre ◽  
Kelvin Naito ◽  
Xinning Li ◽  
Andrew B. Stein
Keyword(s):  
Case Report ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Distal Forearm ◽  
Anatomic Variations ◽  
Transverse Carpal Ligament ◽  
Iatrogenic Injuries ◽  
Flexor Retinaculum

Introduction: Aberrant positioning of the ulnar nerve volar to the transverse carpal ligament is a rare anatomic variation.Case Presentation: We present the case of a 55-year-old female with unique ulnar nerve anatomy that was discovered introperatively during carpal tunnel release.  The ulnar nerve was running directly adjacent to the median nerve in the distal forearm and as the median nerve traversed dorsal to the transverse carpal ligament (flexor retinaculum) to enter the carpal tunnel the ulnar nerve continued directly volar to this structure before angling towards Guyon’s Canal.  The unique ulnar nerve anatomy was successfully identified, carefully dissected and managed with a successful patient outcome.Conclusion: Variations of the anatomy at the level of the carpal tunnel are rare but do exist.  Awareness of these anatomic variations and adequate visualization of the ulnar nerve along with the surrounding structures is crucial to avoid iatrogenic injuries during carpal tunnel release. 

Revision Surgery after Carpal Tunnel Release –Analysis of the Pathology in 200 Cases during a 2 Year Period

2006 ◽  
Vol 31 (1) ◽  
pp. 68-71 ◽  
Author(s):  
N. STÜTZ ◽  
A. GOHRITZ ◽  
J. VAN SCHOONHOVEN ◽  
U. LANZ
Keyword(s):  
Carpal Tunnel ◽  
Revision Surgery ◽  
Carpal Tunnel Release ◽  
Operative Procedure ◽  
Hand Surgery ◽  
Scar Tissue ◽  
Technical Errors ◽  
Number Of Patients ◽  
Release Analysis ◽  
Specific Reason

Carpal tunnel release (CTR) is regarded as a common and successful operative procedure in hand surgery. However, an increasing number of patients with complications have been referred to our hospital. This retrospective investigation was undertaken to clarify the reasons for persisting or recurrent symptoms in 200 patients who underwent secondary exploration during a 26 month period at a single institution. In 108 cases, the flexor retinaculum was found to have been released incompletely. In 12 patients, a nerve laceration had occurred during the primary intervention. In 46 patients, symptoms were due to the nerve being tethered in scar tissue. The re-exploration revealed circumferential fibrosis around and within the median nerve in 17 patients and a tumour in the carpal tunnel in four patients. In 13 patients, no specific reason was found for recurrence of symptoms. We conclude that CTR seems to be a widely underestimated procedure and revision surgery could be largely avoided by reducing technical errors during the primary operation.

scholarly journals The management of failed cubital tunnel decompression

2021 ◽  
Vol 6 (9) ◽  
pp. 735-742
Author(s):  
Abdus S. Burahee ◽  
Andrew D. Sanders ◽  
Dominic M. Power
Keyword(s):  
Outcome Assessment ◽  
Diagnostic Criteria ◽  
Failure Rate ◽  
Carpal Tunnel ◽  
Revision Surgery ◽  
Carpal Tunnel Release ◽  
Nerve Transfer ◽  
Cubital Tunnel ◽  
Quality Research ◽  
Primary Procedure

Cubital tunnel decompression is a commonly performed operation with a much higher failure rate than carpal tunnel release. Failed cubital tunnel release generally occurs due to an inadequate decompression in the primary procedure, new symptoms due to an iatrogenic cause, or development of new areas of nerve irritation. Our preferred technique for failed release is revision circumferential neurolysis with medial epicondylectomy, as this eliminates strain, removes the risk of subluxation, and avoids the creation of secondary compression points. Adjuvant techniques including supercharging end-to-side nerve transfer and nerve wrapping show promise in improving the results of revision surgery. Limited quality research exists in this subject, compounded by the lack of consensus on diagnostic criteria, classification, and outcome assessment. Cite this article: EFORT Open Rev 2021;6:735-742. DOI: 10.1302/2058-5241.6.200135

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