Iatrogenic Injury of the Median Nerve after Surgical Release for Carpal Tunnel Syndrome

Abstract

Currently, carpal tunnel release（CTR）is a common surgical procedure performed in clinical practice. Although this surgery has been demonstrated to be reliable and safe, iatrogenic median nerve injury may infrequently occur. Patients with iatrogenic nerve injury require treatment by experts at specialized centers. This study investigated patients exhibiting iatrogenic injuries of the median nerve following surgical release for carpal tunnel syndrome at our hospital. This study included 7 patients presenting with iatrogenic median nerve injuries after CTR between 2006 and 2017（6 women, 1 man, mean age 64.3 years）. This condition developed in 3 patients following open CTR and in 4 patients following endoscopic CTR before visiting our facility. The mean timing of surgery was 9.7 months after the injury. We performed nerve grafting on all patients, and opponensplasty using the palmaris longus tendon（Camitz transfer）was performed simultaneously for 2 patients. Intraoperatively, complete median nerve injury was observed in 5 and partial injury was observed in 2 patients. In those with complete injury, the mean gap length was 17 mm between the proximal and distal stumps. Thus, it is important that surgeons be aware that CTR is associated with iatrogenic nerve injury.