Postoperative Tethering of a Transligamentous Thenar Motor Branch: A Cause of New-Onset Motor Deficit following Carpal Tunnel Release.

CASE

A 56-year-old woman underwent carpal tunnel release, which was complicated by postoperative tethering and local compression of her transligamentous thenar motor branch (TMB) by the radial leaflet of the transverse carpal ligament (TCL). This resulted in postoperative thenar dysfunction and motor weakness. Revision carpal tunnel release with neurolysis of the median nerve and TMB resulted in improvement.

CONCLUSION

Postoperative tethering of a transligamentous TMB following carpal tunnel release may cause new-onset motor deficiency despite improvements in sensation. This can be treated with neurolysis of the motor branch and decompression of its course through the TCL.