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Treatment of Recurrent Carpal Tunnel Syndrome with the Abductor Digiti Minimi Flap: A Case Series

Department of Plastic, Reconstructive and Hand Surgery, Jeroen Bosch Hospital, 5223 GZ ‘s-Hertogenbosch, The Netherlands

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Wouter F. van LEEUWEN

Department of Plastic, Reconstructive and Hand Surgery, Jeroen Bosch Hospital, 5223 GZ ‘s-Hertogenbosch, The Netherlands

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Jan H. COERT

Department of Plastic, Reconstructive and Hand Surgery, University Medical Center, 3584 CX Utrecht, The Netherlands

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, and

Brigitte van der HEIJDEN

Department of Plastic, Reconstructive and Hand Surgery, Jeroen Bosch Hospital, 5223 GZ ‘s-Hertogenbosch, The Netherlands

Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands

E-mail Address: brigittevanderheijden0@gmail.com

Correspondence to: Brigitte van der Heijden, Department of Plastic, Reconstructive and Hand Surgery, Jeroen Bosch Hospital, PO Box 90153, 5200 ME, Den Bosch, The Netherlands. Tel: +31-73-553-6015.

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https://doi.org/10.1142/S2424835522500710Cited by:2 (Source: Crossref)

Abstract

Background: Approximately 5% of patients experience recurrent symptoms after carpal tunnel release (CTR) and need revision surgery. Several surgical techniques have been described for recurrent carpal tunnel syndrome (CTS) and the abductor digiti minimi (ADM) flap is one of them. Literature concerning clinical results of the ADM flap for recurrent CTS is lacking. The aim of this study is to evaluate the outcomes of the ADM flap for recurrent CTS.

Methods: We treated seven patients with the ADM flap (eight hands) between July 2016 and February 2019. Patient characteristics were assessed, and patients were asked about their symptoms (pain, sensation and paresthesia) before and after surgery. Postoperatively, we administered CTS symptoms, satisfaction with the surgery, patient-reported outcome measurements (BCTQ and QuickDASH) and whether they would undergo the same surgery again. Complications were also recorded

Results: The median follow-up was 14 months. The success rate measured by CTS symptoms was 88%. Seven out of eight patients were satisfied with the results and two patients would not elect to undergo the same procedure again. Two patients reported having a weaker grip at the donor site. The median BCTQ symptom and function scores were 2.9 (1.7–3.5) and 2.6 (1.8–3.0) respectively. The median QuickDASH score was 41 (IQR 22–52). Complications reported were wound dehiscence (n = 1) and hypertrophic scar (n = 1).

Conclusions: The outcomes of the ADM flap in patients with recurrent CTS were like other commonly used procedures in recurrent CTS.

Level of Evidence: Level IV (Therapeutic)

Keywords:

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