Long‐term complications of open carpal tunnel release

Fifty patients who underwent open carpal tunnel release (OCTR) surgery at least 12 months earlier for carpal tunnel syndrome were reviewed, focusing on scar tenderness, pillar pain, and symptoms of neuroma. A total of 55 hands were studied. At an average of 20.2 months of follow‐up, 5.5% had Tinel's sign, 7.3% had scar tenderness, 12.7% had pillar pain, and 18% had burning discomfort. Pillar pain was elicited in a much higher fraction of patients by using the “table test” (provocation of pillar pain by having the patient lean with his/her weight on the hands placed on the edge of a table), even when traditional tests were negative. Symptoms and signs are present in a substantial number of patients after OCTR, even after almost 2 years of follow‐up. Patients should be informed of the incidence of long‐term symptoms and signs after OCTR surgery. Muscle Nerve 38: 1443–1446, 2008

[1]  J. Hopkinson-Woolley,et al.  Standard open decompression in carpal tunnel syndrome compared with a modified open technique preserving the superficial skin nerves: a prospective randomized study. , 2006, The Journal of hand surgery.

[2]  Christopher W C Tong,et al.  Carpal tunnel release with a limited palmar incision: clinical results and pillar pain at 18 months follow-up. , 2005, Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand.

[3]  N Kharwadkar,et al.  Prospective Randomized Trial Comparing Absorbable and Non-Absorbable Sutures in Open Carpal Tunnel Release , 2005, Journal of hand surgery.

[4]  E. Akelman,et al.  Biomechanical and anatomical consequences of carpal tunnel release. , 2003, Clinical biomechanics.

[5]  A. Weiss,et al.  A prospective study of outcome following mini-open carpal tunnel release. , 2003, Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand.

[6]  V. Reale Surgical technique to reduce scar discomfort after carpal tunnel surgery. , 2003, The Journal of hand surgery.

[7]  J. Chow,et al.  Endoscopic carpal tunnel release: thirteen years' experience with the Chow technique. , 2002, The Journal of hand surgery.

[8]  E. Diao,et al.  Single-Portal Endoscopic Carpal Tunnel Release Compared with Open Release: A Prospective, Randomized Trial , 2002, The Journal of bone and joint surgery. American volume.

[9]  L M Bouter,et al.  Systematic review of randomized clinical trials of surgical treatment for carpal tunnel syndrome , 2001, The British journal of surgery.

[10]  S. Avcı,et al.  Carpal Tunnel Release Using a Short Palmar Incision and a New Knife , 2000, Journal of Hand Surgery-American Volume.

[11]  A. Plakseychuk,et al.  Identification and Preservation of Palmar Cutaneous Nerves During Open Carpal Tunnel Release , 1998, Journal of hand surgery.

[12]  A. Weiss,et al.  The results of revision carpal tunnel release following previous open versus endoscopic surgery. , 1998, The Journal of hand surgery.

[13]  J. Sanger,et al.  The Detailed Anatomy of the Palmar Cutaneous Nerves and its Clinical Implications , 1998, Journal of hand surgery.

[14]  W. A. Andrew Lee,et al.  Safe Carpal Tunnel Release via a Limited Palmar Incision , 1998, Plastic and reconstructive surgery.

[15]  B. Povlsen,et al.  Touch Allodynia Following Endoscopic (Single Portal) or Open Decompression for Carpal Tunnel Syndrome , 1997, Journal of hand surgery.

[16]  J. Hall,et al.  Are the Palmar Cutaneous Nerves Safe During Standard Carpal Tunnel Release? , 1996, Annals of plastic surgery.

[17]  H. Zakhour,et al.  Distribution of nerve fibers in the standard incision for carpal tunnel decompression. , 1996, The Journal of hand surgery.

[18]  B. Povlsen,et al.  Incidence and natural history of touch allodynia after open carpal tunnel release. , 1996, Scandinavian journal of plastic and reconstructive surgery and hand surgery.

[19]  J. Seiler,et al.  The cutaneous innervation of the palm: an anatomic study of the ulnar and median nerves. , 1996, The Journal of hand surgery.

[20]  A. Weiss,et al.  Anatomy of the palmar cutaneous branch of the median nerve: clinical significance. , 1996, The Journal of hand surgery.

[21]  G. Watchmaker,et al.  Avoidance of transection of the palmar cutaneous branch of the median nerve in carpal tunnel release. , 1996, The Journal of hand surgery.

[22]  R. X. Murphy,et al.  Midpalmar Approach to the Carpal Tunnel: An Alternative to Endoscopic Release , 1996, Annals of plastic surgery.

[23]  R. G. Simpson,et al.  Late Complications after Open Carpal Tunnel Decompression , 1996, Journal of hand surgery.

[24]  J. Mahoney,et al.  Cutaneous Distribution of the Ulnar Nerve in the Palm: Does It Cross the Incision Used in Carpal Tunnel Release? , 1995, Annals of plastic surgery.

[25]  M. Abouzahr,et al.  Carpal tunnel release using limited direct vision. , 1995, Plastic and reconstructive surgery.

[26]  K. Wilson Double incision open technique for carpal tunnel release: an alternative to endoscopic release. , 1994, The Journal of hand surgery.

[27]  D. Schoenfeld,et al.  Carpal tunnel release. A prospective, randomized assessment of open and endoscopic methods. , 1993, The Journal of bone and joint surgery. American volume.

[28]  A. Biyani,et al.  An Open Twin Incision Technique of Carpal Tunnel Decompression with Reduced Incidence of Scar Tenderness , 1993, Journal of hand surgery.

[29]  M. Devor Neuropathic pain and injured nerve: peripheral mechanisms. , 1991, British medical bulletin.

[30]  H. Gellman,et al.  Complications associated with carpal tunnel release. , 1991, Orthopaedic review.

[31]  Kessler Fb Complications of the management of carpal tunnel syndrome. , 1986 .

[32]  F. Kessler Complications of the management of carpal tunnel syndrome. , 1986, Hand clinics.

[33]  G. Gordillo,et al.  Long-term analysis of patients having surgical treatment for carpal tunnel syndrome. , 1986, The Journal of hand surgery.

[34]  D. Louis,et al.  Complications of carpal tunnel surgery. , 1985, Journal of neurosurgery.

[35]  D. Lichtman,et al.  Complications of surgical release for carpal tunnel syndrome. , 1978, The Journal of hand surgery.

[36]  J. Taleisnik The palmar cutaneous branch of the median nerve and the approach to the carpal tunnel. An anatomical study. , 1973, The Journal of bone and joint surgery. American volume.

[37]  G. S. Phalen,et al.  The carpal-tunnel syndrome. Seventeen years' experience in diagnosis and treatment of six hundred fifty-four hands. , 1966, The Journal of bone and joint surgery. American volume.