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Carpal Tunnel Syndrome pp 319–323Cite as

Hypothenar Fat-Pad Flap

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Abstract

The treatment of scarring of the median nerve in the carpal tunnel following open carpal tunnel release, trauma,or infection presents the hand surgeon with a difficult problem,since adhesions between the nerve and scar tissue in the tunnel impair its longitudinal mobility.Measured in specimens,this amounts to between 7 and 14 mm in a longitudinal direction [1, 2] and some dorso-palmar and radio-ulnar excursion also [3, 4].In some cases the median nerve is even prolapsed and scared between the two ligamentous stumps of the flexor retinaculum after open carpal tunnel release.

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References

  1. Wilgis EFS, Murphy R (1984) The significance of longitudinal excursion in peripheral nerves. Hand Clin, 2, 761–766

    Google Scholar 

  2. Szabo RM, Bay BK, Sharkey NA, Gaut C (1994) Median nerve displacement through the carpal canal. J Hand Surg, 19A, 901–906

    Google Scholar 

  3. Nakamichi K, Tachibana S (1992) Transverse sliding of the median nerve beneath the flexor retinaculum. J Hand Surg, 17B, 213–216

    Google Scholar 

  4. Skie M, Zeiss J, Ebraheim NA, Jackson WT (1990) Carpal tunnel changes and median nerve compression during wrist flexion and extension seen by magnetic resonance imaging. J Hand Surg, 15A, 934–939

    Google Scholar 

  5. Wilhelm K, Putz R, Hierner R, Giunta R (1997) Lappenplastiken in der Handchirurgie — Anatomische Grundlagen, Operationstechniken und Differentialtherapie. Munich Vienna Baltimore, Urban & Schwarzenberg Verlag

    Google Scholar 

  6. Wilgis EFS (1984) Local muscle flaps in the hand anatomy as related to reconstructive surgery. Bull Hosp Jt Dis, 44, 552–557

    CAS  Google Scholar 

  7. Dellon AL, Mackinnon SE (1984) The pronator quadratus muscle flap. J Hand Surg, 9A, 423–427

    Google Scholar 

  8. Ulmer J, Buck-Gramcko D (1988) Der neurovaskulär gestielte Abductor digiti minimi-Muskellappen zur Abdeckung des N. medianus oder seiner Äste. Handchir, 20, 338–341

    CAS  Google Scholar 

  9. Milward TM, Scott WG, Kleinert HE (1977) The abductor digiti minimi muscle flap. Hand, 9, 82–85

    Article  PubMed  CAS  Google Scholar 

  10. Wintsch K, Helaly P (1986) Free flap of gliding tissue. J Reconstr Microsurg, 3, 143–151

    Article  Google Scholar 

  11. Giunta R, Frank U, Lanz U (1998) The hypothenar fat-pad flap for reconstructive repair after scarring of the median nerve at the wrist joint. Ann Chir Main 17:107–112

    Article  CAS  Google Scholar 

  12. Stutz N, Gohritz A, van Schoonhoven J, Lanz U (2006) Revision surgery after carpal tunnelrelease — analysis of the pathology in 200 cases during a 2 year period. J Hand Surg (Br) 31:68–71

    Article  CAS  Google Scholar 

  13. Hunter JM (1991) Recurrent carpal tunnel syndrome, epineural fibrous fixation, and traction neuropathy. Hand Clin, 7, 491–504

    PubMed  CAS  Google Scholar 

  14. Cramer LM (1985) Local Fat Coverage for the Median Nerve. In: Lankford LL (ed.): Correspondence Newsletter for Hand Surgery, 35

    Google Scholar 

  15. Mathoulin CH, Bahm J (1996) Treatment of recalcitrant carpal tunnel syndrome with the hypothenar fat flap. J Hand Surg, 21B(Suppl), 12

    Google Scholar 

  16. Wulle CH (1996) The synovial flap as treatment of the recurrent carpal tunnel syndrome. Hand Clin, 12, 379–388

    PubMed  CAS  Google Scholar 

  17. Rose EH, Norris MS, Kowalski TA et al. (1991) Palmaris brevis turnover flap as an adjunct to internal neurolysis of the chronically scarred median nerve in recurrent carpal tunnel syndrome. J Hand Surg, 16A, 191–201

    Google Scholar 

  18. Plancher KD, Idler RS, Lourie GM, Strickland JW (1996) Recalcitrant carpal tunnel syndrome. Hand Clin, 12, 337–349

    PubMed  CAS  Google Scholar 

  19. Rose EH (1996) The use of the palmaris brevis flap in recurrent carpal tunnel syndrome. Hand Clin, 12, 389–395

    PubMed  CAS  Google Scholar 

  20. Strickland JW, Idler RS, Lourie GM, Plancher KD (1996) The hypothenar fat pad flap for management of recalcitrant carpal tunnel syndrome. J Hand Surg, 21A, 840–848

    Google Scholar 

  21. Rath TH, Millesi H (1990) Das Gleitgewebe des N. medianus im Karpalkanal. Handchir Mikrochir Plast Chir, 22, 203–205

    PubMed  CAS  Google Scholar 

  22. Jones SMG, Stuart PR, Stothard J (1997) Open carpal tunnel release — Does a vascularized hypothenar fat pad reduce wound tenderness? J Hand Surg, 22B, 758–760

    Google Scholar 

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Authors
  1. R. Giunta
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  2. U. Frank
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  3. U. Lanz
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Editor information

Editors and Affiliations

  1. Via Pietro da Rimini 4, 47900, Rimini, Italy

    Riccardo Luchetti M.D.

  2. Mayo Clinic, 200 First Street SW, Rochester, Minnesota, 55905, USA

    Peter Amadio M.D.

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© 2007 Springer-Verlag Berlin Heidelberg

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Giunta, R., Frank, U., Lanz, U. (2007). Hypothenar Fat-Pad Flap. In: Luchetti, R., Amadio, P. (eds) Carpal Tunnel Syndrome. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-49008-1_41

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  • DOI: https://doi.org/10.1007/978-3-540-49008-1_41

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-22387-0

  • Online ISBN: 978-3-540-49008-1

  • eBook Packages: MedicineMedicine (R0)

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