THE HYPOTHENAR FAT PAD FLAP FOR MANAGEMENT OF RECALCITRANT CARPAL-TUNNEL SYNDROME

The hypothenar fat pad flap interposes adipose tissue from the hypothe nar eminence between the median nerve and overlying transverse carpal ligament and surgical scar. This retrospective study reviews 62 hands in 58 patients (46 non-workers' compensation and 16 workers' compensat ion) with recurrent symptoms after failed open carpal tunnel release w ho underwent revision carpal tunnel decompression and in whom a hypoth enar fat pad flap was used. The follow-up period averaged 33 months. P atient satisfaction was 6 in the non-workers' compensation group and 4 in the workers' compensation group. Average time to return to work fo r the non-workers' compensation group was 12 weeks, compared to 37 wee ks for the workers' compensation group. Study results indicate that th e hypothenar fat pad flap produces excellent results in procedures des igned to alleviate recalcitrant idiopathic carpal tunnel syndrome.