Carpal tunnel release is one of the most commonly performed upper extremity procedures. The majority of patients experience significant improvement or resolution of their symptoms. However, a small but important subset of patients will experience the failure of their initial surgery. These patients can be grouped into persistent, recurrent, and new symptom categories. The approach to these patients starts with a thorough clinical examination and is supplemented with electrodiagnostic studies. The step-wise surgical management of revision carpal tunnel surgery consists of the proximal exploration of the median nerve, Guyon's release with neurolysis, the rerelease of the transverse retinaculum, evaluation of the nerve injury, treatment of secondary sites of compression, and potential ancillary procedures. The approach and management of failed carpal tunnel release are reviewed in this article.
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http://dx.doi.org/10.3390/jcm11051386 | DOI Listing |
Orthopadie (Heidelb)
January 2025
Klinik für Handchirurgie und Orthopädie, Spital Langenthal, Spital Region Oberaargau SRO AG, Langenthal, Schweiz.
Pain around the first ray of the hand, particularly in the thumb area, is a frequent clinical problem that can have various causes. This article explores the most important differential diagnoses, including thumb carpometacarpal (CMC-I) osteoarthritis (rhizarthrosis), de Quervain's stenosing tenosynovitis, carpal tunnel syndrome and Wartenberg's syndrome. A detailed medical history, targeted clinical examination and if necessary the use of modern imaging techniques are crucial for making the diagnosis.
View Article and Find Full Text PDFEur J Neurol
February 2025
Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Background: Hereditary transthyretin (ATTRv) amyloidosis is a rare, adult-onset autosomal-dominant disorder caused by pathogenic variants in the transthyretin (TTR) gene. Data about relevant variants in specific populations and typical initial manifestations may facilitate early diagnosis and treatment. We here describe the genetic landscape of ATTRv amyloidosis in Israel.
View Article and Find Full Text PDFJ Hand Microsurg
January 2025
OrthoCarolina Hand Center, Charlotte, NC, USA.
Background: We sought to determine the diagnostic utility of the flexion-compression (F-C) test for carpal tunnel syndrome (CTS). Using electrodiagnostic testing as the gold standard, we hypothesized that the F-C test would be a better diagnostic test for CTS as compared to the wrist flexion (Phalen's) or palmar compression (Durkan's) tests alone.
Methods: We studied patients who presented with and without CTS symptoms, designated as study and control group patients, respectively.
J Hand Microsurg
January 2025
Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Introduction: Carpal tunnel syndrome is a challenging condition when conventional carpal tunnel revision surgery fails to alleviate symptoms. This study aims to assess the outcomes of combining carpal tunnel revision surgery with a synovial wrap for cases of recurrent carpal tunnel syndrome in patients who had adhered median nerve, with a minimum 1-year follow-up.
Patients And Methods: A retrospective analysis was conducted on 10 patients (mean age: 73.
J Hand Microsurg
January 2025
Department of Orthopaedic and Trauma Surgery, AZ Delta, Roeselare, Belgium.
Broader adoption of ultrasound (US) imaging in carpal tunnel syndrome management enhances patient care and outcome. This case underscores the importance in diagnosing carpal tunnel syndrome, highlighting its capability to uncover hidden anomalies and assist in surgical planning.
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