Abstract
The aim of this study was to evaluate whether recurrent carpal tunnel syndrome (CTS) after complete and sufficient division of the transverse ligament really exists. Another goal was to analyze the underlying reasons for recurrent CTS operated on in our department. Over an observation period of eleven years, 156 patients underwent surgical intervention due to CTS. The records of each patient were analyzed with respect to baseline data (age, gender, affected hand), as were clinical signs and symptoms pre- and postoperatively. To assess long-term results, standardized telephone interviews were performed using a structured questionnaire in which the patients were questioned about persisting symptoms, if any. Of the 156 patients, 128 underwent first surgical intervention due to CTS in our department. In long-term follow-up, two-thirds of these patients had no symptoms at all; one-third of the patients described mild persisting numbness. None of the patients experienced a recurrence of CTS. The 28 patients who received their first operation outside of our department were operated on for recurrent CTS. The cause of recurrence was incomplete division of the distal part of the transverse carpal ligament in all cases. The results suggest that recurrent CTS after complete and sufficient division of the transverse ligament is very unlikely.
Highlights
Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment neuropathy [1]
In addition to sensory impairments, motor deficits occur in intrinsic median-innervated muscels such as the abductor pollicis brevis, the superficial belly of the flexor pollicis brevis and opponens pollicis
Of the 128 patients who had undergone first surgical intervention due to CTS in our department, follow-up data 3 months postoperation were available for only 98 patients because 30 patients skipped the follow-up evaluation
Summary
Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment neuropathy [1]. The prevalence of CTS is approximately 5% in the general population [2,3]. It causes pain, numbness and/or tingling in the hand and arm and disturbed motor function of the hand [4,5]. In addition to sensory impairments (e.g., numbness and paresthesias), motor deficits occur in intrinsic median-innervated muscels such as the abductor pollicis brevis, the superficial belly of the flexor pollicis brevis and opponens pollicis. Current operative measures include open, mini-open, and endoscopic decompression of the median nerve at the wrist [1,8,9]
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