The use of free fat grafts in recalcitrant carpal tunnel: a retrospective study

We present a retrospective study evaluating the proclaimed beneficial effec t of the use of fat grafts in patients with recalcitrant carpal tunnel synd rome. Twenty-one re-decompression operations with fat grafting (group I) an d 20 routine re-decompressions (group II) were assessed postoperatively wit h a questionnaire, physical examination, and nerve conduction studies. Both groups were improved by the operative intervention, but no significant dif ferences were found between the two surgical techniques for postoperative s everity of symptoms, threshold sensation, pain assessment, nerve conduction velocities, or patients' satisfaction with the postoperative result. Only the postoperative functional status score of the fat grafted patients revea led a trend to a significantly worse outcome. The fat grafted patients sust ained more problems with a hypersensitive scar at the wrist level immediate ly after surgery, although on long-term review there was no significant dif ference in scar tenderness between the two groups. We concluded that implan tation of free fat grafts has not proved to be of additional benefit in pat ients with recalcitrant carpal tunnel syndrome.