[Principal causes for recurrent carpal tunnel syndrome]

Area of Science:

• Orthopedics
• Neurosurgery
• Hand Surgery

Background:

• Carpal tunnel syndrome (CTS) is a common condition causing hand pain and numbness.
• Recurrence of CTS symptoms after surgical treatment presents a clinical challenge.

Purpose of the Study:

• To investigate the primary causes of relapsing carpal tunnel syndrome.
• To identify factors contributing to symptom recurrence after surgical intervention.

Main Methods:

• A retrospective analysis of nine patients with relapsing CTS from January to December 2011.
• Clinical evaluation including physical examination, Visual Analog Scale (VAS) for pain, and Brigham and Women's Hospital questionnaire for disability.
• Imaging studies were performed to assess anatomical changes.

Main Results:

• Postoperative fibrosis with incomplete carpal tunnel release was the major cause of relapse in seven patients.
• Incomplete release, particularly with minimally invasive approaches, was noted in two patients.
• Three patients developed retractile scars, contributing to symptom recurrence.

Conclusions:

• Postoperative fibrosis, especially when associated with minimally invasive surgical approaches, is a significant cause of carpal tunnel syndrome relapse.
• Incomplete release during carpal tunnel surgery is a primary driver of recurrent symptoms.