Transection of the motor branch of the ulnar nerve as a complication of two-portal endoscopic carpal tunnel release: A case report

1995 ◽  
Vol 20 (1) ◽  
pp. 18-19 ◽  
Author(s):  
L. De Smet ◽  
G. Fabry
Keyword(s):  
Case Report ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Motor Branch ◽  
Endoscopic 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. 

scholarly journals Report of a Transligamentous Ulnar Nerve Sensory Branch

Hand ◽  
2019 ◽  
Vol 15 (1) ◽  
pp. NP11-NP13
Author(s):  
Christina R. Vargas ◽  
Kyle J. Chepla
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Anatomical Variation ◽  
Dominant Male ◽  
Transverse Carpal Ligament ◽  
Anatomical Variant ◽  
Motor Branch ◽  
Right Hand

Background: Several anatomical variations of the median nerve recurrent motor branch have been described. No previous reports have described the anatomical variation of the ulnar nerve with respect to transverse carpal ligament. In this article, we present a patient with symptomatic compression of the ulnar nerve found to occur outside the Guyon canal due to a transligamentous course through the distal transverse carpal ligament. Methods: A 59-year-old, right-hand-dominant male patient presented with right hand pain, subjective weakness, and numbness in both the ulnar and the median nerve distributions. Electromyography revealed moderate demyelinating sensorimotor median neuropathy at the wrist and distal ulnar sensory neuropathy. At the time of planned carpal tunnel and Guyon canal release, a transligamentous ulnar nerve sensory common branch to the fourth webspace was encountered and safely released. Results: There were no surgical complications. The patient’s symptoms of numbness in the median and ulnar nerve distribution clinically improved at his first postoperative visit. Conclusions: We have identified a case of transligamentous ulnar nerve sensory branch encountered during carpal tunnel release. To our knowledge, this has not been previously reported. While the incidence of this variant is unknown, hand surgeons should be aware of this anatomical variant as its location puts it at risk of iatrogenic injury during open and endoscopic carpal tunnel release.

Supraretinacular endoscopic carpal tunnel release: surgical technique with prospective case series

2014 ◽  
Vol 40 (2) ◽  
pp. 193-198 ◽  
Author(s):  
J. Ecker ◽  
N. Perera ◽  
J. Ebert
Keyword(s):  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Case Series ◽  
Level Of Evidence ◽  
Motor Branch ◽  
Endoscopic Techniques ◽  
Endoscopic Carpal Tunnel Release ◽  
Flexor Retinaculum ◽  
Prospective Case Series

Current techniques for endoscopic carpal tunnel release use an infraretinacular approach, inserting the endoscope deep to the flexor retinaculum. We present a supraretinacular endoscopic carpal tunnel release technique in which a dissecting endoscope is inserted superficial to the flexor retinaculum, which improves vision and the ability to dissect and manipulate the median nerve and tendons during surgery. The motor branch of the median nerve and connections between the median and ulnar nerve can be identified and dissected. Because the endoscope is inserted superficial to the flexor retinaculum, the median nerve is not compressed before division of the retinaculum and, as a result, we have observed no cases of the transient median nerve deficits that have been reported using infraretinacular endoscopic techniques. Level of evidence: IV.

scholarly journals Ulnar nerve palsy after open carpal tunnel decompression: Case report and review of the literature

2008 ◽  
Vol 41 (01) ◽  
pp. 73-75
Author(s):  
P. Yoong ◽  
A. Fattah ◽  
A. S. Flemming
Keyword(s):  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Simple Procedure ◽  
Carpal Tunnel Release ◽  
Review Of The Literature ◽  
Motor Branch ◽  
Ulnar Nerve Palsy ◽  
Wrist Anatomy ◽  
Hook Of Hamate ◽  
Open Carpal Tunnel Release

ABSTRACTopen carpal tunnel release is the commonest surgical treatment of median nerve compression at the wrist. although successful in most cases, there are well described complications. we report a case of laceration of the deep motor branch of the ulnar nerve at the level of the hook of hamate following a complicated carpal tunnel decompression. good surgical technique and knowledge of wrist anatomy are essential for performing this apparently simple procedure safely.

Endoscopic Carpal Tunnel Release: A Retrospective Study of the Modified Okutsu Technique Using Glass Tubes

Hand Surgery ◽  
1997 ◽  
Vol 02 (02) ◽  
pp. 123-127
Author(s):  
TM Tsai ◽  
M. Favetto ◽  
R. Elluru
Keyword(s):  
Retrospective Study ◽  
Grip Strength ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Patient Questionnaire ◽  
Endoscopic Carpal Tunnel Release ◽  
Glass Tubes

We evaluated 108 endoscopically assisted carpal tunnel releases in 90 patients in a retrospective study to determine the efficiency and safety of a modified Okutsu endoscopic carpal tunnel release (ECTR) technique. The modification consisted of the use of glass tubes 5, 7, and 9 mm in diameter and a sharp tipped hook knife. The results were evaluated using a patient questionnaire, time off from work, grip strength, and two point discrimination. Symptoms were resolved in 71% of the patients, improved in 19.4%, and not improved in 9.3%. In this series, 59 patients were gainfully employed: 84.7% returned to work, half within 2 weeks of surgery. Severe complications included one laceration of the ulnar nerve, and one neuroma in continuity of the median nerve. ECTR using this modification of Okutsu's technique is effective in the relief of symptoms and returning patients to work quickly.

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