Primary Ring Flexor Digitorum Superficialis Transfer with Open Carpal Tunnel Release in Extreme Carpal Tunnel Syndrome

Lee,  Young Seok; Cheon,  Ho Jun; Kim,  Young Woo; Woo,  Sang Hyun

doi:2017.22.1.34

Arch Hand Microsurg > Volume 22(1); 2017 > Article

Original Article

Journal of the Korean Society for Surgery of the Hand 2017;22(1):34-40.
Published online March 31, 2017.
DOI: https://doi.org/10.12790/jkssh.2017.22.1.34

Primary Ring Flexor Digitorum Superficialis Transfer with Open Carpal Tunnel Release in Extreme Carpal Tunnel Syndrome

Young Seok Lee, Ho Jun Cheon, Young Woo Kim, Sang Hyun Woo

W Institute for Hand and Reconstructive Microsurgery, W Hospital, Daegu, Korea. handwoo@hotmail.com

Received: 1 November 2016 • Revised: 18 January 2017 • Accepted: 27 January 2017

Abstract

Purpose
To analyze the clinical outcome for primary ring flexor digitorum superficialis transfer with open carpal tunnel release in extreme carpal tunnel syndrome.

Methods
Ring flexor digitorum superficialis transfer with open release of the transverse carpal ligament was performed on 23 patients who were diagnosed with extreme carpal tunnel syndrome between September 2008 and August 2013. All patients had visibly severe atrophies, with no sign of compound muscle action potential (CMAP) of abductor pollicis brevis from electromyography. They wanted simultaneous reconstruction of the function of the hand as well as recovery of the numbness. We evaluated the clinical results using key-pinch, hand grip abilities, disability of the arm, shoulder and hand (DASH) scores, Kapandji scores.

Results
Key-pinch and hand grip abilities had no significant difference after the surgery compared with before, but DASH scores were significantly different, averaging 18.6 after, compared with 39.8 before surgery. And Kapandji scores increased significantly from 4.8 before, to 9.3 after the surgery. Numbness and pain in hands were also markedly improved with a different score on VAS each.

Conclusion
Primary ring flexor digitorum superficialis opponensplasty with open carpal tunnel release is a very practical and useful way of treating extreme carpal tunnel syndrome in thenar weakness.