Revision Carpal Tunnel Release in a Case of Proximal Median Nerve Hematoma Injury and Mild Compression 3 Mackinnon SE1 Yee A1 October 11, 2013Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.Complications following carpal tunnel release are uncommon with patients experiencing persistent, recurrent, or new symptoms in the post-operative period. There are multiple etiologies for recurrent carpal tunnel syndrome, which can include traction neuropathy. This is when the epineurium of the median nerve adheres to the surrounding scar tissue and prevents normal nerve gliding leading to traction neuritis. This patient lost median nerve function due to a hematoma compression that developed from a peripherally inserted central catheter in the arm. While this patient did not have sensory function, he was recovering pronator teres and flexor carpi radialis function. For any possibility of sensory recovery, a revision carpal tunnel release was performed to ensure a complete release and mild compression of the median nerve was observed. The median motor function was augmented with a reverse end-to-side nerve transfer. This case is also a demonstration of bifid median nerve in the hand.Keywords: revision surgeryrevision carpal tunnel releaseproximal hematoma compressionbifid median nervecarpal tunnel syndrometraction neuropathyflexor retinaculumnerve decompressiontransverse carpal ligament You must login to view the full article and extended video on this page. Standard Edition Table of Contents- Slow down- Frustration00:00:00 - Introduction00:00:10 - Orientation00:00:15 - Incision00:00:32 - Superficial Exposure00:01:12 - Identifying and Releasing the Flexor Retinaculum00:01:44 - Identifying the Carpal Tunnel00:02:15 - Identifying and Releasing the Tendinous Leading-edge of the Hypothenar Muscles00:02:38 - Identifying the Median Nerve Proximally00:03:01 - Completing the Release of the Flexor Retinaculum00:03:29 - Releasing the Median Nerve from Surrounding Scar Tissue00:03:47 - Identifying the Bifurcation of the Median Nerve00:04:22 - Longitudinal Neurolysis of the Median Nerve00:04:51 - Transverse Neurolysis of the Median Nerve00:05:14 - Application of an Adhesion Barrier on the Median Nerve You must login to view the full article and extended video on this page. Leave a Comment Cancel replyYou must be logged in to post a comment.