Ulnar nerve palsy after open carpal tunnel decompression: Case report and review of the literature

ABSTRACT

open carpal tunnel release is the commonest surgical treatment of median nerve compression at the wrist. although successful in most cases, there are well described complications. we report a case of laceration of the deep motor branch of the ulnar nerve at the level of the hook of hamate following a complicated carpal tunnel decompression. good surgical technique and knowledge of wrist anatomy are essential for performing this apparently simple procedure safely.

KEYWORDS

Carpal tunnel - complications - nerve injury - ulnar nerve

• 1 Franzblau A, Werner RA. What is carpal tunnel syndrome?. JAMA 1999; 282: 186-7
• 2 Thurston A, Lam N. Results of open carpal tunnel release: A comprehensive, retrospective study of 188 hands. Aust N Z J Surg 1997; 67: 283-8
• 3 MacDonald RI, Lichman DM, Hanlon JJ, Wilson JN. Complications of surgical release for carpal tunnel syndrome. J Hand Surg Am 1978; 3: 70-6
• 4 Polatsch DB, Melone Jr CP, Beldner S, Incorvaia A. Ulnar nerve anatomy. Hand Clin 2007; 23: 283-9
• 5 Favero KJ, Gropper PT. Ulnar nerve laceration: A complication of carpal tunnel decompression: A case report and review of the literature. J Hand Surg Br 1987; 12: 239-41
• 6 Terrono AL, Belsky MR, Feldon PG, Nalebuff EA. Injury to the deep motor branch of the ulnar nerve during carpal tunnel release. J Hand Surg Am 1993; 18: 1038-40
• 7 Ahcan U, Arnez Z, Bajrovic F, Zorman P. Surgical technique to reduce scar discomfort after carpal tunnel surgery. J Hand Surg Am 2002; 27: 821-7
• 8 Taleisnik J.. The palmar cutaneous branch of the median nerve and the approach to the carpal tunnel. J Bone Joint Surg Am 1973; 55: 1212-7
• 9 Matloub HS, Yan JG, Mink Van Der Molen AB, Zhang LL, Sanger JR. The detailed anatomy of the palmar cutaneous nerves and its clinical implications. J Hand Surg Br 1998; 23: 373-9
• 10 Engber WD, Gmeiner MD. Palmar cutaneous branch of the ulnar nerve. J Hand Surg 1980; 5: 26-9
• 11 Born T, Mahoney J. Cutaneous distribution of the ulnar nerve in the palm: Does it cross the incision used in carpal tunnel release?. Ann Plast Surg 1995; 35: 23-5
• 12 Martin CH, Seiler 3rd JG, Lesesne JS. The cutaneous innervation of the palm: An anatomic study of the ulnar and median nerves. J Hand Surg Am 1996; 21: 634-8