title: [Surgical treatment of persisting and recurrent carpal tunnel syndrome from 1999 to 2003].
abstract: The operative treatment of carpal tunnel syndrome is relatively simple and is carried out by doctors from various surgical specialities. In cases of persisting pain or postoperative worsening of the condition, the indication for the procedure could have been wrong or an iatrogenic complication may have to be taken into consideration. We have analysed 42 patients (48 hands) who underwent surgical treatment for carpal tunnel release from 1999 to 2003. We treated eight men and 34 women with an average age of 56 years in this way. Ten patients were initially operated upon by endoscopic release. We found an incompletely transected or even untouched retinaculum flexorum in 16 patients. In eight patients we found an iatrogenic nerve lesion and 24 patients developed serious scarring. Revision surgery should be undertaken only by a surgeon who is a specialist in hand surgery and has extensive experience in this field. In the same context, postoperative hand therapy is essential for a good result, which is performed by occupational therapists in our clinic.
authors.affiliation: Universitätsklinik für Plastische und Wiederherstellungschirurgie, Medizinische Universität Innsbruck. petra.puelzl@uibk.ac.at
authors.forename: P
authors.initials: P
authors.lastname: Pülzl
authors.forename: D
authors.initials: D
authors.lastname: Estermann
authors.forename: H
authors.initials: H
authors.lastname: Piza-Katzer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000601:surgery*; D002908:Chronic Disease; D002921:Cicatrix / Q000601:surgery; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*; D012008:Recurrence; D012017:Referral and Consultation; D012086:Reoperation; D013038:Specialization