Department of Plastic, Reconstructive and Hand Surgery, Jeroen Bosch Hospital, 5223 GZ 's-Hertogenbosch, The Netherlands.
Department of Plastic, Reconstructive and Hand Surgery, University Medical Center, 3584 CX Utrecht, The Netherlands.
J Hand Surg Asian Pac Vol. 2022 Aug;27(4):698-705. doi: 10.1142/S2424835522500710. Epub 2022 Aug 11.
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. 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 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 ( = 1) and hypertrophic scar ( = 1). The outcomes of the ADM flap in patients with recurrent CTS were like other commonly used procedures in recurrent CTS. Level IV (Therapeutic).
约 5%的腕管松解 (CTR) 术后患者会出现症状复发，需要再次手术。已经描述了几种治疗复发性腕管综合征 (CTS) 的手术技术，其中之一是小指展肌 (ADM) 皮瓣。关于 ADM 皮瓣治疗复发性 CTS 的临床结果的文献很少。本研究旨在评估 ADM 皮瓣治疗复发性 CTS 的结果。我们在 2016 年 7 月至 2019 年 2 月期间治疗了 7 例 ADM 皮瓣患者（8 只手）。评估了患者的特征，并在术前和术后询问了他们的症状（疼痛、感觉和感觉异常）。术后评估了 CTS 症状、手术满意度、患者报告的结果测量（BCTQ 和 QuickDASH）以及他们是否会再次接受相同的手术。还记录了并发症。中位随访时间为 14 个月。根据 CTS 症状测量的成功率为 88%。8 例患者中有 7 例对结果满意，2 例患者不会再次选择相同的手术。2 例患者报告供区握力较弱。中位 BCTQ 症状和功能评分分别为 2.9（1.7-3.5）和 2.6（1.8-3.0）。中位 QuickDASH 评分为 41（IQR 22-52）。报告的并发症有切口裂开 ( = 1) 和肥厚性瘢痕 ( = 1)。ADM 皮瓣治疗复发性 CTS 的结果与复发性 CTS 中常用的其他手术相似。IV 级（治疗）。
