Management of recurrent carpal tunnel syndrome with microneurolysis and the hypothenar fat pad flap

摘要: A retrospective chart review for the period between 1998 and 2006 was conducted to evaluate microneurolysis combined with a hypothenar fat pad flap (HTFPF) patients at Mayo Clinic, Scottsdale, Arizona, who were being treated recurrent carpal tunnel syndrome. After exclusion of incomplete release transverse ligament time original operation, 28 consecutive identified. Their average age 68.5 years (range 43–89 years). The interval reexploration 82 months 5–298 months). follow-up 10.5 3–48.4 preoperative two-point discrimination tests averaged 7 mm 5–12 mm). At surgery, all found have fibrosis surrounding median nerve adherence radial leaf ligament. Tinel sign disappeared in 26 improved an 6 4–8 Postoperative grip strength 20 kg, compared 11 kg preoperatively. Pain completely 83% (average improvement 93%, range 5–100%). Numbness 42% 82.9%, Tingling 50% 84.7%, No patient reported worse after reoperation. These results suggest that combination HTFPF can restore gliding provide soft-tissue coverage, improving symptoms