Can flexor tenosynovectomy and microsurgical epineurectomy improve clinical outcomes following open carpal tunnel release?

Duman, Serda; Şahin, Vedat; Sofu, Hakan; Çamurcu, Yalkın; Üçpunar, Hanifi

doi:10.1051/sicotj/2017009

Cited by 1 publication

(1 citation statement)

References 26 publications

(20 reference statements)

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“…Although they did not find evidence to recommend FTS for routine primary CTR, it has shown a benefit in certain cases. 18 Duman et al 29 demonstrated a significant improvement in QuickDASH scores among patients receiving FTS and microsurgical epineurectomy in addition to CTR compared with patients receiving CTR alone. Strickland et al 30 retrospectively reviewed 62 revision carpal tunnel cases in which a hypothenar fat pad flap was used (100% of cases), in addition to external neurolysis (94%), internal neurolysis (11%), and FTS (10%).…”

Section: Discussionmentioning

confidence: 99%

Flexor Tenosynovectomy for Recurrent Carpal Tunnel Syndrome: A Retrospective Case Series of 108 Hands

Kluemper

Swafford

Hankins

et al. 2019

Hand (New York, N,Y.)

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Background: The etiology of recurrent carpal tunnel syndrome (CTS) is unclear, and outcomes following secondary surgery in this demographic have been poorer than primary surgery. Fibrosis and hypertrophy have been identified in the flexor tenosynovium in these patients. The authors use flexor tenosynovectomy (FTS) for recurrent CTS after primary carpal tunnel release and present a review of these patients. Methods: A retrospective chart review was performed of 108 cases of FTS for recurrent CTS from 1995 to 2015 by 4 attending surgeons at one institution. Demographic information, symptoms, and outcomes were among the data recorded. A phone survey was conducted on available patients where the shortened version of the Disabilities of the Arm, Shoulder and Hand Questionnaire (QuickDASH) and satisfaction were assessed. Results: Average office follow-up was 12 months. Average age was 57.5 years. A total of 104 (96%) reported symptom improvement and 48 (44%) reported complete symptom resolution. Forty patients were available for long-term follow-up at an average 6.75 years postoperatively via phone interview. Average QuickDASH score was 31.2 in these patients. Thirty-six (90%) of 40 patients were initially satisfied at last office visit, and 31 (78%) of 40 were satisfied at average 6.9 years, a maintenance of satisfaction of 86%. Satisfied patients were older (58 years) than unsatisfied patients (51 years). Conclusion: Both long-term satisfaction and QuickDASH scores in our cohort are consistent with or better than published results from nerve-shielding procedures. The authors believe a decrease in both carpal tunnel volume and potential adhesions of fibrotic or inflammatory synovium contributes to the benefits of this procedure. This remains our procedure of choice for recurrent CTS.

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Section: Discussionmentioning

confidence: 99%