Nanofat and Platelet Rich Plasma to Enhance Recovery and Minimize Risk of Recurrence after Endoscopic Carpal Tunnel Release

Carpal tunnel release is one of the most common and surgery procedures performed. Complications and recurrence of the condition can occur up to 20% of cases. We describe a technique of utilizing the nanofat and platelet rich plasma to successfully enhance healing and minimize risk of recurrence after endoscopic carpal tunnel release. This patient had exceptionally fast recovery, resuming work in one day and excellent grip strength and a full functioning level at his two-week follow-up. After one year he continues to demonstrate a complete resolution of symptoms and full function without any evidence of recurrence or complications.

[1]  T. Tawonsawatruk,et al.  Hypothenar fat pad flap vs conventional open release in primary carpal tunnel syndrome: A randomized controlled trial , 2017, World journal of orthopedics.

[2]  C. Ketonis,et al.  Neurolysis with Amniotic Membrane Nerve Wrapping for Treatment of Secondary Wartenberg Syndrome: A Preliminary Report. , 2017, The journal of hand surgery Asian-Pacific volume.

[3]  S. Brammer,et al.  Hypothenar fat pad flap surgery for end stage and recurrent carpal tunnel syndrome. , 2016, Hand surgery & rehabilitation.

[4]  Gioacchino,et al.  Carpal Tunnel Release: Avoiding Complications with Layer Shield Matrix , 2016 .

[5]  A. Mavrogenis,et al.  Median nerve biodegradable wrapping : Clinical outcome of 10 patients. , 2016, Acta orthopaedica Belgica.

[6]  J. English,et al.  Incidence of Carpal Tunnel Syndrome Requiring Surgical Decompression: A 10.5-Year Review of 2,309 Patients. , 2015, The Journal of hand surgery.

[7]  P. Papagelopoulos,et al.  Collagen nerve wrap for median nerve scarring. , 2015, Orthopedics.

[8]  A. Copay,et al.  The Use of a Dehydrated Amnion/Chorion Membrane Allograft in Patients Who Subsequently Undergo Reexploration after Posterior Lumbar Instrumentation , 2015, Advances in orthopedics.

[9]  P. Papagelopoulos,et al.  Collagen Nerve Wrap for Median Nerve , 2015 .

[10]  Wael A. M. Nassar,et al.  New technique for reducing fibrosis in recurrent cases of carpal tunnel syndrome. , 2014, 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.

[11]  Ann Marie Dale,et al.  Prevalence and incidence of carpal tunnel syndrome in US working populations: pooled analysis of six prospective studies. , 2013, Scandinavian journal of work, environment & health.

[12]  P. Taylor,et al.  INCIDENCE OF CARPAL TUNNEL SYNDROME REQUIRING SURGICAL DECOMPRESSION: A 10.5 YEAR REVIEW OF 2309 PATIENTS IN A SINGLE REGION , 2012 .

[13]  N. Jones,et al.  Revision Surgery for Persistent and Recurrent Carpal Tunnel Syndrome and for Failed Carpal Tunnel Release , 2012, Plastic and reconstructive surgery.

[14]  U. Lanz,et al.  [Results after revision surgery for carpal tunnel release]. , 2008, Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V....

[15]  D. Le Nen,et al.  [Free dermal fat graft for coverage of the median nerve following failed carpal tunnel release]. , 2008, Chirurgie de la main.

[16]  G. Raimbeau [Recurrent carpal tunnel syndrome]. , 2008, Chirurgie de la main.

[17]  R. Sanders,et al.  Observations on the Use of Seprafilm® on the Brachial Plexus in 249 Operations for Neurogenic Thoracic Outlet Syndrome , 2007, Hand.

[18]  U. Lanz,et al.  Revision Surgery after Carpal Tunnel Release –Analysis of the Pathology in 200 Cases during a 2 Year Period , 2006, Journal of hand surgery.

[19]  A. Uchida,et al.  Enhancement of Perineurial Repair and Inhibition of Nerve Adhesion by Viscous Injectable Pure Alginate Sol , 2005, Plastic and reconstructive surgery.

[20]  M. Ozveren,et al.  Seprafilm superior to Gore-Tex in the prevention of peridural fibrosis. , 2004, Journal of neurosurgery.

[21]  A. E. Bagatur [Analysis of the causes of failure in carpal tunnel syndrome surgery and the results of reoperation]. , 2002, Acta orthopaedica et traumatologica turcica.

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

[23]  U. Joosten,et al.  [Implantation of oxidized, regenerated cellulose for prevention of recurrence in surgical therapy of carpal tunnel syndrome]. , 1997, Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V....

[24]  C. Peimer,et al.  Long-Term Results of Carpal Tunnel Release , 1995, Journal of hand surgery.

[25]  S. Mackinnon,et al.  Subjective and Employment Outcome Following Secondary Carpal Tunnel Surgery , 1994, Annals of plastic surgery.

[26]  L. Millender,et al.  Factors that determine reexploration treatment of carpal tunnel syndrome. , 1992, The Journal of hand surgery.

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