Eroğlu A, Sarı E, Topuz AK, Şimşek H, Pusat S. Recurrent carpal tunnel syndrome: Evaluation and treatment of the possible causes. World J Clin Cases 2018; 6(10): 365-372 [PMID: 30283799 DOI: 10.12998/wjcc.v6.i10.365]
Corresponding Author of This Article
Ahmet Eroğlu, MD, Surgeon, Department of Neurosurgery, Haydarpaşa Sultan Abdülhamid Education and Research Hospital, Selimiye Neighborhood, Tibbiye Street, Istanbul 34000, Turkey. drahmeteroglu@gmail.com
Research Domain of This Article
Neurosciences
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 26, 2018; 6(10): 365-372 Published online Sep 26, 2018. doi: 10.12998/wjcc.v6.i10.365
Recurrent carpal tunnel syndrome: Evaluation and treatment of the possible causes
Ahmet Eroğlu, Enes Sarı, Ali Kıvanç Topuz, Hakan Şimşek, Serhat Pusat
Ahmet Eroğlu, Hakan Şimşek, Serhat Pusat, Department of Neurosurgery, Haydarpaşa Sultan Abdülhamid Education and Research Hospital, Istanbul 34000, Turkey
Enes Sarı, Department of Orthopaedics and Traumatology, Near East University Hospital, Lefkoşa 99010, Cyprus
Ali Kıvanç Topuz, Department of Neurosurgery, Baypark Hospital, Istanbul 34000, Turkey
Author contributions: Eroğlu A contributed to the idea for research or article/hypothesis generation, supervision and responsibility for the organisation and course of the project and the manuscript preparation; Sarı E planed the methods to generate hypothesis and takes responsibility for creation of the entire or a substantial part of the manuscript; Topuz AK took responsibility for conducting literature search; Şimşek H reworked the final, before submission version of the manuscript for intellectual content, not just spelling and grammar check; Pusat S took responsibility for creation of the entire or a substantial part of the manuscript.
Institutional review board statement: The manuscript has been approved by Ministry of Health Haydarpaşa Sultan Abdülhamid Education and Research Hospital, Review Board of Neurosurgery.
Informed consent statement: It has been declared that all relevant persons involved (subjects or legally authorized representative) gave their informed consent (written or verbal, as appropriate).
Conflict-of-interest statement: All authors have no conflicts of interest to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ahmet Eroğlu, MD, Surgeon, Department of Neurosurgery, Haydarpaşa Sultan Abdülhamid Education and Research Hospital, Selimiye Neighborhood, Tibbiye Street, Istanbul 34000, Turkey. drahmeteroglu@gmail.com
Telephone: +90-506-2036231 Fax: +90-216-5422815
Received: April 8, 2018 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 Processing time: 171 Days and 13.4 Hours
Abstract
AIM
To investigate the causes of the recurrent carpal tunnel syndrome (CTS) and implemented surgical interventions.
METHODS
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.
RESULTS
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.
CONCLUSION
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.
