Synovial Flap for Recurrent Carpal Tunnel Syndrome: Long-Term Follow-Up

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Neuroscience

Background:

• Recurrent carpal tunnel syndrome presents a significant surgical challenge.
• Revision carpal tunnel release with vascularized flap coverage is considered for median nerve scarring.
• Long-term outcomes of synovial flap coverage during neurolysis remain underreported.

Purpose of the Study:

• To evaluate the long-term outcomes (>1 year) of revision carpal tunnel release with synovial flap coverage.
• To assess the efficacy of this technique in managing recurrent carpal tunnel syndrome.

Main Methods:

• Retrospective review of 17 patients undergoing revision carpal tunnel release and synovial flap coverage.
• Data collection included demographics, preoperative symptoms, and telephone follow-up surveys.
• Utilized QuickDASH and Boston Carpal Tunnel Questionnaire (BCTQ) for outcome assessment; Fisher exact test for analysis.

Main Results:

• 71.43% of patients achieved good outcomes based on BCTQ scores (<2).
• 78.57% of patients reported good outcomes using QuickDASH scores (≤34).
• All patients deemed the surgery successful, with 13 willing to repeat the procedure; no major complications reported.

Conclusions:

• Revision carpal tunnel release with synovial flap coverage demonstrates favorable long-term patient-reported outcomes.
• This surgical approach is a reliable and effective treatment for recurrent carpal tunnel syndrome.
• The technique shows promise for managing challenging cases of persistent carpal tunnel syndrome.