Carpal Tunnel Syndrome (Feat. Dr. Mackinnon)

Carpal Tunnel Syndrome
Authors: Mackinnon SE1, Yee A1
Published: May 16, 2016

AUTHOR INFORMATION
1 Division of Plastic and Reconstructive Surgery, Washington University, St. Louis, Missouri

DISCLOSURE
No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.

ABSTRACT
This presentation discusses carpal tunnel syndrome (CTS) and median neuropathy in the context of compression neuropathies. In particular, this presentation details the specific nuances for (1) an open carpal tunnel release, (2) revision carpal tunnel surgery, and (3) decompression of the median nerve in the forearm. Patients that fail the primary carpal tunnel release and require secondary surgery, present with either persistent, recurrent, or new symptoms. This classification for revision surgery is discussed to indicate the nature of the patient’s problem and define the appropriate management. Additionally, the technical nuances for decompression of the median nerve in the forearm are presented.

TABLE OF CONTENTS
00:00 Introduction
00:06 CARPAL TUNNEL SYNDROME
00:10 Pain Evaluation
00:58 Pre-operative and Post-operative Therapy
01:12 Overview
02:05 Carpel Tunnel Synovium
02:35 Carpal Tunnel Release
02:40 Incision for Carpal Tunnel Release
03:35 Transverse Carpal Ligament
05:21 Location of Ligament Release
05:53 Surgical Technique for Carpal Tunnel Release
06:47 Extended Incision for Increase in Body Mass Increase
06:54 Revision Carpal Tunnel Surgery
07:25 Persistent, Recurrent, or New Symptoms for Carpal Tunnel Syndrome
08:44 Surgical Technique for Revision Carpal Tunnel Release
09:33 Neurolysis for Bands of Fontana
09:52 Longitudinal and Transverse Neurolysis
10:50 Median Nerve Reconstruction for Iatrogenic Nerve Injuries
12:56 MEDIAN NERVE COMPRESSION IN THE FOREARM
13:22 Median Nerve Release in the Forearm
13:26 Step-lengthening the Pronator Teres
14:59 Decompression of the Medial Nerve
17:05 Conclusion