The tenosynovial flap for recalcitrant carpal tunnel syndrome

Operative intervention for recalcitrant carpal tunnel syndrome often utilizes local vascularized tissue to provide coverage of the median nerve in an attempt to limit scarring or adherence of the nerve to its surrounding structures. Although the hypothenar fat pad is the most commonly cited source of vascularized tissue, alternative options do exist. We review the technique of utilizing a pedicled tenosynovial flap as the source of local vascularized tissue for coverage of the median nerve in cases of recalcitrant carpal tunnel syndrome.