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Updated: Sep 17, 2025
04:08
Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
637
Re-Exploration Carpal Tunnel Surgery for Iatrogenic Median Nerve Injuries
Vicki McClure1, Jieyun Zhou1, Scott Ferris1
1Alfred Health, Plastic and Reconstructive Surgery Unit, Melbourne, Victoria, Australia.
ANZ Journal of Surgery
|July 2, 2025
Summary
Carpal tunnel release (CTR) is usually effective, but some patients experience persistent symptoms requiring re-operation. Early identification and referral for exploratory surgery by a reconstructive microsurgeon can improve outcomes.
Area of Science:
- Hand surgery
- Peripheral nerve disorders
- Microsurgery
Background:
- Carpal tunnel syndrome (CTS) is a common upper limb nerve entrapment.
- Carpal tunnel release (CTR) is a frequent surgical procedure.
- A subset of patients experience persistent or recurrent symptoms after CTR, necessitating re-exploration.
Purpose of the Study:
- To present a case series of patients with persistent symptoms after carpal tunnel release.
- To discuss indications and management strategies for failed CTR.
- To emphasize the importance of timely referral and specialized surgical intervention.
Main Methods:
- Case series of four patients referred for persistent symptoms post-CTR.
- Review of indications for primary CTR and outcomes.
- Discussion of reasons for surgical failure and re-exploration.
Main Results:
- Patients presented with new, persistent, or recurrent symptoms after initial CTR.
- Indications for re-exploration included suspected incomplete release or nerve injury.
- The study highlights the need for prompt identification and referral.
Conclusions:
- Carpal tunnel release is generally successful, but complications can occur.
- Persistent symptoms post-CTR warrant prompt evaluation and potential re-exploration.
- Reconstructive microsurgeons are ideally suited for revision CTR to optimize patient outcomes.
