Skip to main content

Advertisement

SpringerLink
Log in

Sonography before and after carpal tunnel release: video article

  • Pictorial Essay
  • Published:
Journal of Ultrasound Aims and scope Submit manuscript

Abstract

Carpal tunnel release for compression of the median nerve at the wrist is a common procedure, often resulting in good clinical outcomes. There are, however, many anatomical variations in and around the carpal tunnel and it is important to be aware of these during carpal tunnel release. After surgery, recurrent carpal tunnel syndrome is uncommon, but difficult to diagnose and treat. Ultrasonography is often necessary for the evaluation of the anatomical variations before carpal tunnel release and to evaluate the most common complications after carpal tunnel release.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bianchi S, Beaulieu JY, Poletti PA (2020) Ultrasound of local complications in hand surgery: a pictorial essay. J Ultrasound Med. https://doi.org/10.1007/s40477-020-00457-8(Epub ahead of print)

    Article  PubMed  Google Scholar 

  2. Rodrigues J, Santos-Faria D, Silva J, Azevedo S, Tavares-Costa J, Teixeira F (2019) Sonoanatomy of anterior forearm muscles. J Ultrasound 22(3):401–405

    Article  Google Scholar 

  3. Draghi F, Bianchi S, Gervasio A, Fachinetti C, Gaignot C, de Gautard R (2006) Ultrasound of traumatic disorders of wrist and hand. J Ultrasound 9:218–226

    Google Scholar 

  4. Tagliafico A, Pugliese F, Bianchi S et al (2008) High-resolution sonography of the palmar cutaneous branch of the median nerve. AJR Am J Roentgenol 191(1):107–114

    Article  Google Scholar 

  5. Bianchi S, Draghi F, Beggs I (2011) Ultrasound of the peripheral nerves. In: Allan P, Baxter GM, Weston MJ (eds) Clinical ultrasound, vol 2. Elsevier, Philadelphia, pp 1158–1167

    Chapter  Google Scholar 

  6. Mitchell R, Chesney A, Seal S, McKnight L, Thoma A (2009) Anatomical variations of the carpal tunnel structures. Can J Plast Surg 17(3):e3–7

    Article  Google Scholar 

  7. Demircay E, Civelek E, Cansever T, Kabatas S, Yilmaz C (2011) Anatomic variations of the median nerve in the carpal tunnel: a brief review of the literature. Turk Neurosurg 21(3):388–396. https://doi.org/10.5137/1019-5149.JTN.3073-10.1

    Article  PubMed  Google Scholar 

  8. Henry BM, Zwinczewska H, Roy J, Vikse J, Ramakrishnan PK, Walocha JA, Tomaszewski KA (2015) The prevalence of anatomical variations of the median nerve in the carpal tunnel: a systematic review and meta-analysis. PLoS ONE 10(8):e0136477. https://doi.org/10.1371/journal.pone.0136477(eCollection 2015. Review. Erratum in: PLoS One. 2015;10(9):e0138300)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Presazzi A, Bortolotto C, Zacchino M, Madonia L, Draghi F (2011) Carpal tunnel: normal anatomy, anatomical variants and ultrasound technique. J Ultrasound 14(1):40–46

    Article  CAS  Google Scholar 

  10. Chen L, Chen J, Hu B, Jiang LX (2017) Sonographic findings of the bifid median nerve and persistent median artery in carpal tunnel: a preliminary study in Chinese individuals. Clinics 72(6):358–362

    Article  Google Scholar 

  11. Barbuto L, Di Serafino M, Della Vecchia N, Rea G, Esposito F, Vezzali N, Ferro F, Caprio MG, Vola EA, Romeo V, Vallone G (2019) Pediatric musculoskeletal ultrasound: a pictorial essay. J Ultrasound 22(4):491–502

    Article  Google Scholar 

  12. Martinoli C, Bianchi S, Gandolfo N et al (2000) US of nerve entrapments in osteofibrous tunnels of the upper and lower limbs. Radiographics 20:199–217

    Article  Google Scholar 

  13. Santosa KB, Chung KC, Waljee JF (2015) Complications of compressive neuropathy: prevention and management strategies. Hand Clin 31(2):139–149. https://doi.org/10.1016/j.hcl.2015.01.012(Epub 2015 Mar 2)

    Article  PubMed  PubMed Central  Google Scholar 

  14. Mosier BA, Hughes TB (2013) Recurrent carpal tunnel syndrome. Hand Clin 29(3):427–434. https://doi.org/10.1016/j.hcl.2013.04.011(Epub 2013 Jun 27)

    Article  PubMed  Google Scholar 

  15. Karl JW, Gancarczyk SM, Strauch R (2016) Complications of carpal tunnel release. Orthop Clin N Am 47(2):425–433. https://doi.org/10.1016/j.ocl.2015.09.015

    Article  Google Scholar 

  16. Jones NF, Ahn HC, Eo S (2012) Revision surgery for persistent and recurrent carpal tunnel syndrome and for failed carpal tunnel release. Plast Reconstr Surg 129(3):683–692. https://doi.org/10.1097/PRS.0b013e3182402c37

    Article  CAS  PubMed  Google Scholar 

  17. Vidoni A, Shrivastava M, Botchu R (2018) Intrasynovial spindle cell lipoma of the deep flexor of the middle finger causing intermittent carpal tunnel syndrome-case report and review of the literature. J Ultrasound. https://doi.org/10.1007/s40477-018-0281-x(Epub ahead of print)

    Article  PubMed  Google Scholar 

  18. Gitto S, Draghi AG, Draghi F (2018) Sonography of non-neoplastic disorders of the hand and wrist tendons. J Ultrasound Med 37(1):51–68

    Article  Google Scholar 

  19. Gitto S, Draghi F (2016) Normal sonographic anatomy of the wrist with emphasis on assessment of tendons, nerves, and ligaments. J Ultrasound Med 35(5):1081–1094

    Article  Google Scholar 

  20. Riegler G, Pivec C, Platzgummer H, Lieba-Samal D, Brugger P, Jengojan S, Vierhapper M, Bodner G (2017) High-resolution ultrasound visualization of the recurrent motor branch of the median nerve: normal and first pathological findings. Eur Radiol 27(7):2941–2949. https://doi.org/10.1007/s00330-016-4671-1(Epub 2016 Dec 12)

    Article  PubMed  Google Scholar 

  21. Klauser A, Halpern EJ, Faschingbauer R et al (2011) Bifid median nerve in carpal tunnel syndrome: assessment with US cross-sectional area measurement. Radiology 250:808–815

    Article  Google Scholar 

  22. Frick A, Baumeister RG (2006) Re-intervention after carpal tunnel release. Handchir Mikrochir Plast Chir 38(5):312–316

    Article  CAS  Google Scholar 

  23. Stütz N, Gohritz A, van Schoonhoven J, Lanz U (2006) Revision surgery after carpal tunnel release–analysis of the pathology in 200 cases during a 2 year period. J Hand Surg Br 31(1):68–71 (Epub 2005 Oct 27)

    Article  Google Scholar 

  24. Kim JK, Kim YK (2011) Predictors of scar pain after open carpal tunnel release. J Hand Surg Am 36(6):1042–1046

    Article  Google Scholar 

  25. Sueleyman T, Staub F, Dombert T et al (2015) Sonographic short-term follow-up after surgical decompression of the median nerve at the carpal tunnel: a single-center prospective observational study. Neurosurg Focus 39:1–5

    Google Scholar 

  26. Bianchi S, Becciolini M, Urigo C (2019) Ultrasound of disorders of small nerves of the extremities Less recognized localizations. J Ultrasound Med 38(11):2821–2842

    Article  Google Scholar 

  27. Gervasio A, Stelitano C, Bollani P, Giardini A, Vanzetti E, Ferrari M (2020) Carpal tunnel sonography. J Ultrasound. https://doi.org/10.1007/s40477-020-00460-z(Epub ahead of print)

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Radiology Institute, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi, Pavia, Italy

    Ferdinando Draghi, Chandra Bortolotto, Daniela Ballerini & Lorenzo Preda

  2. Diagnostic Imaging Department, Centro Medico Inacqua, Piacenza, Italy

    Guia Ferrozzi

  3. Diagnostic Imaging Department, Centro Medico Riabilitativo Rocca, Piacenza, Italy

    Guia Ferrozzi

  4. Unit of Interventional Radiology-Radiology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Ilaria Fiorina

Authors
  1. Ferdinando Draghi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guia Ferrozzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chandra Bortolotto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daniela Ballerini
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ilaria Fiorina
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lorenzo Preda
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniela Ballerini.

Ethics declarations

Conflict of interest

CB: consultant for Bracco imaging and doc congress. The other authors have no conflict of interest to declare related to this study.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

Research involving human participants and/or animals

The study described in this article does not involve the use of animal subjects.

Informed consent

The patient provided written informed consent to enrolment in the study and to the publication of information that could potentially lead to his identification.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (MP4 111056 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Draghi, F., Ferrozzi, G., Bortolotto, C. et al. Sonography before and after carpal tunnel release: video article. J Ultrasound 23, 363–364 (2020). https://doi.org/10.1007/s40477-020-00465-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40477-020-00465-8

Keywords

Search

Navigation