[Surgically treated carpal tunnel syndrome--clinical and electrophysiologic follow-up]

The carpal tunnel syndrome is described as a compression of the N. medianus under the retinaculum flexorum with the causes for this syndrome being of the most varied nature. The aetiology is multifactorial with frequent alterations of the connective tissue being observed in the histological specimen, i.e. chronic inflammatory proliferations or fibrotic degenerations. Direct pressure measurements have shown that the pressure is markedly higher both at rest and extension or flexion as compared to normal healthy subjects. An exact diagnosis requires a measurable prolongation of the distal motorial latency. Surgery is the treatment of choice to ensure perfect recovery. For this purpose the retinaculum flexorum must be entirely split, and our experiments have shown that the splitting of the epineurium yields good results. The microsurgical interfascicular neurolysis, however, should be considered in special cases only. Complaints tend to disappear fairly quickly in the majority of cases, i.e. pain recedes by 90%, sensitivity disorders by more than 70% and muscle atrophy by 50%. The operation enables a measurable improvement of the distal motorial latency. The incidence of postoperative complications is relatively low, and if they do occur, then they are negligible and without any bearing on the final surgical result. Persistent residual complaints are very often due to other accompanying diseases such as cervical vertebral column syndrome, cervical ribs etc.