Management of Recalcitrant Carpal Tunnel Syndrome.

Journal Article (Journal Article;Review)

Recalcitrant carpal tunnel syndrome presents a clinical challenge. Potential etiologies of persistent or recurrent symptoms after primary carpal tunnel release include incomplete nerve decompression, secondary sites of nerve compression, unrecognized anatomic variations, irreversible nerve pathology associated with chronic compression neuropathy, perineural adhesions, conditions associated with secondary nerve compression, iatrogenic nerve injury, or inaccurate preoperative diagnosis. Understanding the pertinent surgical anatomy and pathophysiology is essential toward developing an effective diagnostic and treatment strategy. A thorough clinical history and examination guide a comprehensive diagnostic evaluation that includes serial examinations, neurophysiologic testing, and imaging studies. Conservative treatment may provide symptomatic relief; however, surgical management involving revision neuroplasty, neurolysis, nerve reconstruction, and/or local soft-tissue flap augmentation may be indicated in refractory cases.

Full Text

Duke Authors

Cited Authors

  • Lauder, A; Mithani, S; Leversedge, FJ

Published Date

  • August 1, 2019

Published In

Volume / Issue

  • 27 / 15

Start / End Page

  • 551 - 562

PubMed ID

  • 30973521

Electronic International Standard Serial Number (EISSN)

  • 1940-5480

Digital Object Identifier (DOI)

  • 10.5435/JAAOS-D-18-00004

Language

  • eng

Conference Location

  • United States