Simultaneous modified Camitz opponensplasty using a pulley at the radial side of the flexor retinaculum in severe carpal tunnel syndrome

2013 ◽  
Vol 39 (6) ◽  
pp. 632-636 ◽  
Author(s):  
N. Kato ◽  
T. Yoshizawa ◽  
H. Sakai
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Radial Side ◽  
Palmaris Longus ◽  
Flexor Retinaculum ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release

Camitz opponensplasty using the palmaris longus has been used in patients undergoing open carpal tunnel release. It is considered to have several advantages over other opponensplasty techniques, but it provides weak flexion and pronation, which are prerequisites for opposition. To address this shortcoming, we have used a modified Camitz procedure with a pulley at the radial side of the dissected flexor retinaculum and have assessed the results in comparison with the conventional Camitz procedure. Both procedures provided significant improvements in palmar abduction and Disabilities of the Arm, Shoulder, and Hand and Kapandji scores at 3 months post-operatively, but patients who underwent the modified Camitz procedure showed better improvement in pulp pinch, palmar abduction, and thumb pronation.

Thumb Function and Electromyography Result after Modified Camitz Tendon Transfer

2017 ◽  
Vol 22 (03) ◽  
pp. 275-280 ◽  
Author(s):  
Claire Marie Durban ◽  
Bernard Antolin ◽  
Chung Ying Sau ◽  
Sheung Wai Li ◽  
Wing Yuk Ip
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Pinch Strength ◽  
Muscle Recovery ◽  
Abductor Pollicis Brevis ◽  
Palmaris Longus ◽  
Contralateral Hand ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release

Background: Various techniques of opponensplasty have been developed with the aim of restoring the thumb function. The modified Camitz opponensplasty is a simple technique done together with an open carpal tunnel release. It restores thumb palmar abduction soon after the procedure, during such time that the abductor pollicis brevis (APB) is still recovering. The aim of this study was to assess the recovery and level of activity of the abductor pollicis brevis and palmaris longus (PL) muscles during thumb opposition and abduction after performing the modified Camitz opponensplasty. Methods: The records of 21 patients who underwent modified Camitz opponensplasty for severe carpal tunnel syndrome were reviewed. Thumb function was evaluated using the Van Wetter Apogee test, Kapandji index, tripod pinch strength, and power grip. Electromyography was utilized to evaluate APB recovery; ultrasonography was employed to evaluate PL activity. Results: Twenty patients reached 80% of the abduction height of the contralateral hand; the Kapandji index was good in thirteen. Palmaris longus activity was evaluated together with the APB muscle recovery. There was significant improvement in the average grip strength and average tripod pinch strength. However, this did not correlate with the degree of neurologic and muscular recovery of the APB. We surmise that the palmaris longus augmented the abductor pollicis brevis muscle even in those with full muscle recovery. Conclusions: The modified Camitz opponensplasty is a practical option for patients suffering from severe carpal tunnel syndrome with diminished thumb function.

The Anatomical Site of Constriction of the Median Nerve in Patients with Severe Idiopathic Carpal Tunnel Syndrome

2006 ◽  
Vol 31 (6) ◽  
pp. 608-610 ◽  
Author(s):  
M. M AL-QATTAN
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Anatomical Site ◽  
Idiopathic Carpal Tunnel Syndrome ◽  
Tunnel Syndrome ◽  
A Prospective Study ◽  
Open Carpal Tunnel Release ◽  
Radiological Studies

During open carpal tunnel release in patients with severe idiopathic carpal tunnel syndrome, an area of constriction in the substance of the median nerve is frequently noted. In a prospective study of 30 patients, the central point of the constricted part of the nerve was determined intraoperatively and found to be, on average, 2.5 (range 2.2–2.8) cm from the distal wrist crease. This point always corresponded to the location of the hook of the hamate bone. These intraoperative findings were compared with the “narrowest” point of the carpal canal as determined by anatomical and radiological studies in the literature.

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.

A RECURRENT CASE OF CARPAL TUNNEL SYNDROME IN HAEMODIALYSIS

Hand Surgery ◽  
2002 ◽  
Vol 07 (02) ◽  
pp. 299-303 ◽  
Author(s):  
Kenji Yamauchi
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Open Surgery ◽  
Haemodialysis Patient ◽  
Carpal Tunnel Release ◽  
Recurrent Case ◽  
Tunnel Syndrome ◽  
The Right ◽  
Open Carpal Tunnel Release ◽  
Bilateral Carpal Tunnel Syndrome

Herein is described a haemodialysis patient with bilateral carpal tunnel syndrome suffering from recurrence unilaterally after undergoing numerous surgeries of varying methods. On the left side, she received carpal tunnel release via open method in our clinic, and has not suffered from recurrence in eight years. On the right side, she received endoscopic carpal tunnel release twice in seven years, and subsequently underwent open carpal tunnel release in our clinic for recurrence. For carpal tunnel syndrome in haemodialysis patients, we recommend open surgery rather than endoscopic surgery.

scholarly journals Mini-open Carpal Tunnel Release

2018 ◽  
Vol 19 (4) ◽  
pp. 21-27
Author(s):  
Paulo Henrique Pires De Aguiar ◽  
Carlos Alexandre Martins Zicarelli ◽  
Fabio V. C. Sparapani ◽  
Pedro Augusto De Santana Jr ◽  
Alexandros Theodoros Panagoupolos ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Neurological Deficits ◽  
Motor Branch ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release ◽  
Nerve Entrapment Syndrome ◽  
Mini Open

Introduction: Median nerve compression is the most common nerve entrapment syndrome. After carpal tunnel release, patients often complain about the scar cosmetic appearance. Objective: The aim of our study was to evaluate the clinical outcome, surgical technique and complications of mini-open carpal release. Methods: We reviewed data from 48 surgical procedures for Carpal Tunnel Syndrome in 32 patients at the Pinheiros Neurologicaland Neurosurgical Clinic in the period of 2000 and 2008. The mean age was 49 years-old. We used a 2 cm incision and microscopic technique to obtain meticulous access of the palmar hand anatomy with special attention to both the recurrent motor branch and palmar cutaneous nerve. Results: Twenty-two patients had total resolution of symptoms. Two patients had no change of neurological symptoms. During the follow up no infection or neurological deficits were observed. Conclusion: Mini-open is a safe and effective approach for carpal tunnel syndrome release. However detailed palmar hand anatomy is mandatory to prevent lesion of branching palmar nerve. The use of microscope is desirable to help identify important structures and avoid complications.

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