Secondary carpal tunnel surgery

A small but significant group of patients with carpal tunnel syndrome "fail " primary carpal tunnel release and require secondary surgery. The persiste nce or recurrence of previous symptoms or the development of new symptoms i s often indicative of the nature of the patient's problem. Postoperative co mplications may be classified into the general areas of neurological, vascu lar, tendon, and wrist complaints. A thorough clinical evaluation, includin g a complete neurological examination of the hand and upper extremity, prov ides an accurate assessment of the status of the median nerve. Important su rgical techniques that may be used during secondary carpal tunnel surgery i nclude internal neurolysis, neuroma-in-continuity assessment, neuroma manag ement, nerve grafting, and tissue interposition flaps.