title: Internal neurolysis fails to improve the results of primary carpal tunnel decompression.
abstract: This prospective, randomized study compares two treatment methods in patients with primary carpal tunnel syndrome. Decompression of the transverse carpal ligament was done in thirty-two hands (thirty patients) and decompression of the transverse carpal ligament with the addition of an internal neurolysis of the median nerve was done in thirty-one hands (twenty-nine patients). Relief of symptoms was described in eighty-eight percent of the patients with carpal ligament release and eighty-one percent of patients with carpal ligament release plus internal neurolysis. Improvement in hand sensibility testing, in thenar muscle strength, and atrophy was noted in both treatment groups with no statistical difference between groups. The addition of an internal neurolysis to division of the transverse carpal ligament does not add significant improvement in the sensory or motor outcome of patients with primary carpal tunnel syndrome.
authors.affiliation: University of Toronto, Division of Plastic Surgery, Ont., Canada.
authors.forename: S E
authors.initials: SE
authors.lastname: Mackinnon
authors.forename: S
authors.initials: S
authors.lastname: McCabe
authors.forename: J F
authors.initials: JF
authors.lastname: Murray
authors.forename: J P
authors.initials: JP
authors.lastname: Szalai
authors.forename: L
authors.initials: L
authors.lastname: Kelly
authors.forename: C
authors.initials: C
authors.lastname: Novak
authors.forename: B
authors.initials: B
authors.lastname: Kin
authors.forename: G M
authors.initials: GM
authors.lastname: Burke
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008022:Ligaments / Q000601:surgery*; D008297:Male; D008475:Median Nerve / Q000601:surgery*; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D011446:Prospective Studies; D012677:Sensation / Q000502:physiology