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Updated: May 10, 2026

Structured Motor Rehabilitation After Selective Nerve Transfers
Published on: August 15, 2019
Postoperative Tethering of a Transligamentous Thenar Motor Branch: A Cause of New-Onset Motor Deficit following
Emily M Pflug1, Alexander Lauder2,3, Matthew D Folchert2,3
1Department of Orthopedics, NYU Langone Health, New York, New York.
Case:
A 56-year-old woman underwent carpal tunnel release, which was complicated by postoperative tethering and local compression of her transligamentous thenar motor branch (TMB) by the radial leaflet of the transverse carpal ligament (TCL). This resulted in postoperative thenar dysfunction and motor weakness. Revision carpal tunnel release with neurolysis of the median nerve and TMB resulted in improvement.
Conclusion:
Postoperative tethering of a transligamentous TMB following carpal tunnel release may cause new-onset motor deficiency despite improvements in sensation. This can be treated with neurolysis of the motor branch and decompression of its course through the TCL.
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