title: Correlations between ultrasonography findings and surgical findings in patients with refractory symptoms after primary surgical release for carpal tunnel syndrome.
abstract: OBJECTIVE
  Surgical carpal tunnel release is very effective for symptom relief in carpal tunnel syndrome, and it remains the preferred choice of treatment. However, refractory symptoms following surgical release are not uncommon. We aimed to assess the usefulness of ultrasonography for determining the potential causes of ongoing symptoms following surgical release.
  
  
  METHODS
  This retrospective study included 34 patients (32 women; mean age, 54.7±16.65 years; range: 30 to 81 years) with carpal tunnel syndrome who underwent surgical carpal tunnel release.
  
  
  RESULTS
  A pathology related to the cause of the ongoing symptoms was detected by ultrasonography in 25 (74.5%) patients. The most common pathological findings were median nerve swelling (70.6%), incomplete transection of the transverse carpal ligament (23.5%) and perineural fibrosis (17.6%).
  
  
  CONCLUSIONS
  In the majority of the patients the pathology related to the ongoing symptoms was detected by ultrasonography, suggesting that ultrasonography could be used as a complementary imaging method for identifying the causes of failure following surgical carpal tunnel release. Detection of an ongoing pathology might help clinicians in managing persistent disease cases and aid in planning an exploration.
authors.affiliation: Dokuz Eylül University Faculty of Medicine, Department of Radiology, İzmir, Turkey. nurikarabay@gmail.com.
authors.forename: Nuri
authors.initials: N
authors.lastname: Karabay
authors.affiliation: EMOT Hospital, Department of Orthopedics and Traumatology, İzmir, Turkey.
authors.forename: Tulgar
authors.initials: T
authors.lastname: Toros
authors.affiliation: EMOT Hospital, Department of Radiology, İzmir, Turkey.
authors.forename: Erkin
authors.initials: E
authors.lastname: Çetinkol
authors.affiliation: EMOT Hospital, Department of Orthopedics and Traumatology, İzmir, Turkey.
authors.forename: Sait
authors.initials: S
authors.lastname: Ada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008475:Median Nerve / Q000000981:diagnostic imaging*; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography