Free vascularized omental transfer for the treatment of recalcitrant carpal tunnel syndrome

Abstract

Patients with recurrent or persistent carpal tunnel syndrome (CTS)despite a properly performed carpal tunnel release (CTR)can be quite difficult to manage and classically have poor outcomes [1-3].Multiple etiologies may be responsible for their persistent symptoms including excessive scar formation around the median nerve resulting in limited nerve mobility otherwise known as adhesive median neuritis or neurodesis (Fig.49.1)[4-7].In addition,patients with persistent symptoms may have irreversible nerve injury from internal fibrosis secondary to chronic compression or even iatrogenic causes resulting in a neuroma.These patients may also have a limited incentive for improvement or issues of secondary gain such as workman's compensation or ongoing litigation. © 2007 Springer-Verlag Berlin Heidelberg.