Perforator-based radial forearm fascial flap for management of recurrent carpal tunnel syndrome

Mostafa Mahmoud, Sherif El Shafie, Erin E. Coppola, John C. Elfar

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose To study the benefit of using the perforator-based radial forearm fascial flap for patients with recurrent carpal tunnel syndrome. Methods We used a perforator-based radial forearm fascial flap in 8 patients to cover the median nerve. All of the patients had undergone an index carpal tunnel release, and 3 of them had undergone at least 1 revision surgery to further decompress the median nerve. Results At average of 20 months (range, 6-30 mo) after the forearm fascial flap, all patients reported symptomatic improvement with complete resolution of nighttime symptoms. No patient reported worsening of symptoms; however, some subjective parasthesias persisted in 3 of the 8 patients. Objective assessment revealed complete resolution of a Tinel sign in 5 of 8 patients and noteworthy improvement in the remaining 3 patients. Average 2-point discrimination was 10.0 mm before surgery and 5.4 mm after surgery, average grip strength improved from 13.5 kg to 21.0 kg, and average tip pinch strength improved from 4.1 kg to 7.0 kg. Conclusions The perforator-based radial forearm fascial flap may prove useful in the setting of recurrent carpal tunnel syndrome after surgical decompression. Level of evidence Therapeutic IV.

Original languageEnglish (US)
Pages (from-to)2151-2158
Number of pages8
JournalJournal of Hand Surgery
Volume38
Issue number11
DOIs
StatePublished - Nov 1 2013

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Carpal Tunnel Syndrome
Forearm
Median Nerve
Pinch Strength
Surgical Decompression
Hand Strength
Wrist
Reoperation

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Mahmoud, Mostafa ; El Shafie, Sherif ; Coppola, Erin E. ; Elfar, John C. / Perforator-based radial forearm fascial flap for management of recurrent carpal tunnel syndrome. In: Journal of Hand Surgery. 2013 ; Vol. 38, No. 11. pp. 2151-2158.
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Perforator-based radial forearm fascial flap for management of recurrent carpal tunnel syndrome. / Mahmoud, Mostafa; El Shafie, Sherif; Coppola, Erin E.; Elfar, John C.

In: Journal of Hand Surgery, Vol. 38, No. 11, 01.11.2013, p. 2151-2158.

Research output: Contribution to journalArticle

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N2 - Purpose To study the benefit of using the perforator-based radial forearm fascial flap for patients with recurrent carpal tunnel syndrome. Methods We used a perforator-based radial forearm fascial flap in 8 patients to cover the median nerve. All of the patients had undergone an index carpal tunnel release, and 3 of them had undergone at least 1 revision surgery to further decompress the median nerve. Results At average of 20 months (range, 6-30 mo) after the forearm fascial flap, all patients reported symptomatic improvement with complete resolution of nighttime symptoms. No patient reported worsening of symptoms; however, some subjective parasthesias persisted in 3 of the 8 patients. Objective assessment revealed complete resolution of a Tinel sign in 5 of 8 patients and noteworthy improvement in the remaining 3 patients. Average 2-point discrimination was 10.0 mm before surgery and 5.4 mm after surgery, average grip strength improved from 13.5 kg to 21.0 kg, and average tip pinch strength improved from 4.1 kg to 7.0 kg. Conclusions The perforator-based radial forearm fascial flap may prove useful in the setting of recurrent carpal tunnel syndrome after surgical decompression. Level of evidence Therapeutic IV.

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