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Open AccessArticle

Surgery of True Recurring Median Carpal Tunnel Syndrome with Synovial Flap by Wulle Plus Integument Enlargement Leads to a High Patient’s Satisfaction and Improved Functionality

1
Department of Orthopaedics and Trauma Surgery, Medical University of Vienna, 1180 Vienna, Austria
2
Department of Plastic Surgery, University Clinic of Vienna, General Hospital of Vienna, 1090 Vienna, Austria
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(12), 2094; https://doi.org/10.3390/jcm8122094
Received: 14 November 2019 / Revised: 27 November 2019 / Accepted: 29 November 2019 / Published: 1 December 2019
(This article belongs to the Section Orthopedics)
This prospective study was conducted to investigate electrophysiological qualities and patient’s satisfaction of a synovial gliding tissue flap in treating true recurring carpal tunnel syndrome. In 14 patients (11 women, three men), 15 median nerves were included in this retrospective study. For all 15 nerves, motor and sensory nerve conduction velocity, compound muscle action potential, a Visual Analogue Scale-score (VAS-score) questionnaire and an adapted Levine-Test were evaluated pre- and postoperatively. All participants underwent operative neurolysis of the median nerve, which was then enwrapped by a synovial gliding tissue flap. Eleven procedures were completed by integument enlargement. Follow-up period was 12 months. Postoperatively, distal latency decreased significantly by 15.6%. Compound muscle action potential and sensory nerve conduction velocity did not improve significantly. VAS score regarding pain reduced highly significantly with 74.1%. The adapted Levine-Test function score improved highly significantly with 39.2%. The synovial gliding tissue flap lead to an excellent patient’s satisfaction for treating true recurring carpal tunnel syndrome. Primary wound closure should be completed with integument enlargement if needed.
Keywords: flap coverage by Wulle; integument enlargement; recurrent CTS; synovial flap flap coverage by Wulle; integument enlargement; recurrent CTS; synovial flap
MDPI and ACS Style

Payr, S.; Tiefenboeck, T.M.; Moser, V.; Turkof, E. Surgery of True Recurring Median Carpal Tunnel Syndrome with Synovial Flap by Wulle Plus Integument Enlargement Leads to a High Patient’s Satisfaction and Improved Functionality. J. Clin. Med. 2019, 8, 2094.

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