Published online Sep 26, 2018. doi: 10.12998/wjcc.v6.i10.365
Peer-review started: April 8, 2018
First decision: May 16, 2018
Revised: July 25, 2018
Accepted: August 11, 2018
Article in press: August 11, 2018
Published online: September 26, 2018
To investigate the causes of the recurrent carpal tunnel syndrome (CTS) and implemented surgical interventions.
Four hundred and eighty-seven patients, who were diagnosed with CTS and underwent surgical intervention between October 2016 and September 2007, were evaluated in this retrospective study. The age, gender, physical evaluation findings, electrophysiological examination reports and implemented surgical treatment methods were analyzed.
Thirty-nine of the cases were operated due to recurrent CTS. Further examination of the patients with recurrent CTS revealed that ten cases had diabetic polyneuropathy, three cases had hypothyroidism, two cases had rheumatoid arthritis and one case had systemic amyloidosis. Postoperative electromyography confirmed the neuropathy was due to systemic diseases. The remaining 23 patients with recurrent CTS did not have any systemic disease and all of them had applied previously to another health center.
We concluded that the recurrence rates in CTS might be decreased with exploration and incision of the entire transverse ligament. Damage to the motor and sensory branches of the median nerve could be avoided with an incision on the ulnar side.
Core tip: In this study, 23 cases of recurrent carpal tunnel syndrome did not have any systemic disease and all of them had undergone a surgical intervention in another center. The incision was made starting distal to the volar wrinkle, passed between the thenar and hypothenar region, 2-3 mm medially to the thenar wrinkle and extended 2-3 cm to the lateral side of the third finger. In recurrent cases, an appropriate differential diagnosis, re-operation without delay to avoid the development of the interfacial fibrosis, and implementation of a precise and careful surgical technique play important roles in improving the surgical outcome.