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Revision Carpal Tunnel Surgery Options

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Carpal Tunnel Syndrome and Related Median Neuropathies

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Abstract

Carpal tunnel syndrome (CTS) affects 1% of the general population and 5% of the working population. Consequently, carpal tunnel release (CTR) is one of the most common procedures performed on the hand. Median nerve entrapment symptoms at the carpal tunnel after CTR can be defined as either failed (persistent or new symptoms) or recurrent CTS. Recurrent CTS is characterized by a symptom-free interval after surgery. The cause of recurrent carpal tunnel is thought to be due to progressive constriction of the nerve via scar formation.

There are a number of methods to manage perineural fibrosis, a condition thought to be responsible for recurrent compression and restricted nerve gliding. These include procedures to isolate the nerve from scar and others that are intended to bring neovascularization to the median nerve. While many surgical procedures for recurrent CTS have been described in the literature, there is a paucity of comparative studies on the subject. Almost all published articles report on results of a single technique or a few techniques, without a comparison of efficacy. This chapter describes the surgical techniques for recurrent CTR and their reported outcomes.

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Acknowledgments

The authors would like to thank Joelle Tighe, BS, and Edward Donley, BS, for their assistance in preparing this manuscript.

Disclosure

The authors have no financial interest to declare in relation to the content of this chapter.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 2000 Oxford Drive, Bethel Park, 15102, Suite 510, Pittsburgh, PA, 15102, USA

    Yaron Sela, Lindsay Hess & Mark E. Baratz

  2. Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Orthopaedic Specialists - UPMC, 9104 Babcock Blvd, 5th Floor, Pittsburgh, PA, 15237, USA

    Loukia K. Papatheodorou & Dean G. Sotereanos

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  1. Yaron Sela
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  2. Loukia K. Papatheodorou
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  3. Lindsay Hess
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  4. Dean G. Sotereanos
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  5. Mark E. Baratz
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Corresponding author

Correspondence to Mark E. Baratz .

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Editors and Affiliations

  1. Department of Orthopedic Surgery, Boston University/Boston Medical Center, Boston, Massachusetts, USA

    Scott F. M. Duncan

  2. Department of Orthopaedic Surgery, Kindai University Hospital, Osaka, Japan

    Ryosuke Kakinoki

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Sela, Y., Papatheodorou, L.K., Hess, L., Sotereanos, D.G., Baratz, M.E. (2017). Revision Carpal Tunnel Surgery Options. In: Duncan, S., Kakinoki, R. (eds) Carpal Tunnel Syndrome and Related Median Neuropathies. Springer, Cham. https://doi.org/10.1007/978-3-319-57010-5_16

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  • DOI: https://doi.org/10.1007/978-3-319-57010-5_16

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