Ulnar Nerve Injury Following Open Carpal Tunnel Release: A Case Report

Abstract

Carpal tunnel syndrome (CTS) is one of the most common peripheral nerve diseases. It is managed medically and if not, resolved by surgical procedure. Decompression of the carpal tunnel is considered the definitive treatment. There are multiple complications after this procedure, which can be classified into three categories: (I) persistent, (II) recurrent, or (III) new symptoms, and ulnar nerve palsy after decompression of the carpal tunnel is a rare complication. In this study, we present a case of carpal tunnel decompression, which was complicated by ulnar nerve palsy, which exacerbated a pre-existing chronic ulnar nerve injury. We also explore the possible causes that may have led to this outcome.

The Isolated Motor Branch of the Ulnar Nerve Injury During Open Carpal Tunnel Release

“…Recently, postoperative MUN injury was also observed. Ashi et al proposed that the injury could be a result of a large hematoma formation in the hand and wrist after surgery [ 14 ]. Therefore, a proper tourniquet inflation, bleeding control, and the use of local anesthetic agent with adrenaline can aid in clear and meticulous dissection [ 5 , 13 ].…”

Iatrogenic median and ulnar nerve injuries during carpal tunnel release: clinical, electrodiagnostic, and ultrasound features in 12 patients. Patient series

“…6,11,12 Injury to the median nerve (often the palmar cutaneous branch or recurrent motor branch) is most frequent; ulnar nerve injury is rare. 6,11,13,14 Failure of CTR may be divided into symptoms that are persistent (incomplete release of the flexor retinaculum due to inadequate exposure and visualization), recurrent (scar formation in the carpal tunnel), or new (additional hypesthesia, more severe lancinating and shooting pain, worsened numbness, new motor deficit) immediately or shortly after CTR. 1,3,9,14 We report 12 patients who sustained iatrogenic median or ulnar nerve injury during CTR, all of whom underwent electrodiagnostic (EDX) studies and 11 of whom had ultrasound (US) studies.…”