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Herein is described a haemodialysis patient with bilateral carpal tunnel syndrome suffering from recurrence unilaterally after undergoing numerous surgeries of varying methods. On the left side, she received carpal tunnel release via open method in our clinic, and has not suffered from recurrence in eight years. On the right side, she received endoscopic carpal tunnel release twice in seven years, and subsequently underwent open carpal tunnel release in our clinic for recurrence. For carpal tunnel syndrome in haemodialysis patients, we recommend open surgery rather than endoscopic surgery.

The purpose of this study was to evaluate risk factors for re-recurrent carpal tunnel syndrome (CTS) in long-term renal hemodialysis (HD) patients. Fifteen wrists of ten HD patients, follow-up period of minimum seven years after reoperation of CTS, were included in this study. Duration of HD, period from first operation to reoperation, shunt side was involved or not, presence of trigger finger and cervical destructive spondyloarthritis, and operative procedure performed during the reoperation (synovectomy was performed or not) were evaluated. Re-recurrent CTS was identified in four out of 15 wrists (27%). The period from first operation to reoperation, which was 3.8 years in the re-recurrence group and eight years in the no re-recurrence group, and the operative procedure had significant differences (synovectomy groups had no re-recurrence vs. no synovectomy groups had 82% re-recurrence). The results of this study suggested that synovectomy would be necessary for recurrent CTS in HD patients.

The objective of this study is to analyze the effects and benefits of subtotal synovectomy in the early stage of septic arthritis. seventy rabbits with septic arthritis of the left knee joint were treated at 24 or 72 hours after inoculation of Staphylococcus aureus, with different treatment modalities, including antibiotic therapy, arthrotomy, irrigation, and synovectomy. At the end of the 6th week, the knee joints were removed and examined both macroscopically and histologically. It was discovered that there was more significant degeneration at the articular surface of the femur than that of the tibia. antibiotic therapy alone was found to be insufficient to prevent the degeneration of articular cartilage. performing subtotal synovectomy had no statistically significant effect 24 hours after the inoculation of bacteria. However, adding subtotal synovectomy to the surgical drainage 72 hours after inoculation resulted in significantly lesser degeneration of the articular cartilage. Sufficient drainage and irrigation of the joint associated with antibiotic treatment seems to be an adequate choice of treatment at the very early stage of septic arthritis. However, in established septic arthritis, adding subtotal synovectomy to the surgical drainage resulted in significantly lesser degeneration of the articular cartilage.

Background: Carpal tunnel release (CTR) aims to achieve surgical decompression of the median nerve for the treatment of carpal tunnel syndrome (CTS). Flexor tenosynovectomy (FS) has been carried out as an adjunct to routine CTR, on the basis that chronic flexor tenosynovitis has been implicated as an etiological factor in idiopathic CTS. However, the benefits of this additional procedure remains unclear. As such, we aimed to compare functional outcomes, nerve function and complication rates from CTR with and without FS.

Methods: A systematic review of published literature was performed for original data English language studies comparing outcomes of CTR with and without FS in the treatment of primary CTS. Mean weighted differences and their 95% confidence interval were used for analysis.

Results: Three studies comprising 292 wrists were included. Meta-analysis showed no improvement in post-operative grip strength, symptom severity score, functional status score, median nerve motor latency or major complications with FS. Recurrence rate was not reported in the 3 selected articles.

Conclusions: The available evidence suggests FS is an unnecessary adjunct which provides no benefit to CTR, and should not be used routinely to treat primary CTS. Larger studies are needed to validate our findings. FS may have a role in recurrent or secondary CTS.