Annals of Rehabilitation Medicine

Ulnar Neuropathy at the Wrist in a Patient with Carpal Tunnel Syndrome after Open Carpal Tunnel Release: Nack Hwan Kim, Dong Hwee Kim; Ann Rehabil Med 2012;36(2):291-296. Published online April 30, 2012; DOI: https://doi.org/10.5535/arm.2012.36.2.291

Abstract
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Ulnar neuropathy at the wrist is rarely reported as complications of carpal tunnel release. Since it can sometimes be confused with recurrent median neuropathy at the wrist or ulnar neuropathy at the elbow, an electrodiagnostic study is useful for detecting the lesion in detail. We present a case of a 51-year-old woman with a two-week history of right ulnar palm and 5^th digit tingling sensation that began 3 months after open carpal tunnel release surgery of the right hand. Electrodiagnostic tests such as segmental nerve conduction studies of the ulnar nerve at the wrist were useful for localization of the lesion, and ultrasonography helped to confirm the presence of the lesion. After conservative management, patient symptoms were progressively relieved. Combined electrodiagnostic studies and ultrasonography may be helpful for diagnosing and detecting ulnar neuropathies of the wrist following carpal tunnel release surgery.

Citations

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Localization of Ulnar Neuropathy at the Wrist Using Motor and Sensory Ulnar Nerve Segmental Studies
Ki Hoon Kim, Beom Suk Kim, Min Jae Kim, Dong Hwee Kim
Journal of Clinical Neurology.2022; 18(1): 59. CrossRef
Ultrasound-Guided Perineural Injection at Guyon's Tunnel: An Anatomic Feasibility Study
Stefan Meng, Ines Tinhofer, Wolfgang Grisold, Wolfgang J. Weninger
Ultrasound in Medicine & Biology.2015; 41(8): 2119. CrossRef
Ultrasound Imaging of Median and Ulnar Nerves After Carpal Tunnel Surgery
Serdar Can Güven, Asl Çalşkan, Sina Yasrebi, Levent Özçakar
American Journal of Physical Medicine & Rehabilitation.2013; 92(11): 1035. CrossRef
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A Long-Term Follow Up Study of Prognostic Factors after Carpal Tunnel Release.: Yang, Seung Nam , Yoon, Joon Shik , Kim, Sei Joo , Kim, Gui Sang; J Korean Acad Rehabil Med 2006;30(6):580-583.

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Objective
The purpose of this study was to examine the factor influencing the improvement of symptoms and change of electrophysiologic findings of patients after carpal tunnel release. Method: We examined 16 patients (27 hands) who underwent carpal tunnel release operation after diagnosed with carpal tunnel syndrome by the electrodiagnostic study from March 2000 to February 2001. Nerve conduction tests and visual analogue scale were performed pre-operateively and 1 month and 3 years post-operatively. We also performed a correlation study to measure the improvements of symptoms with the patient's age, duration of symptoms, and severity of works. Results: The improvement of visual analogue scale had no correlation with the age, severity of work and visual analogue scale at pre-operation. However, there was significant relationship between the improvement of visual analogue scale and duration of symptom. Conclusion: These findings suggest that the benifits of the carpal tunnel release operation were influenced by the patient's duration of the symptoms. The longer the symptoms were experienced, the improvements of the symptoms were reduced. (J Korean Acad Rehab Med 2006; 30: 580-583)

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Outcomes of Carpal Tunnel Release in Diabetic and Non-Diabetic Patients.: Yoon, Dae Won , Kwon, Hee Kyu; J Korean Acad Rehabil Med 2005;29(1):70-75.

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Objective
To compare the surgical outcomes of carpal tunnel release in diabetic and non-diabetic patients. Method: Among the patients who underwent carpal tunnel release for carpal tunnel syndrome, 44 subjects (77 hands) were recruited and classified into two patient groups: group 1 composed of 20 subject (36 hands) with diabetes mellitus and group 2 with 24 subjects (41 hands) without diabetes mellitus. Electrodiagnostic parameters were included onset latency, peak latency, and amplitude of median motor and sensory nerves pre- and postoperatively. Also symptom (visual analogue scale) and complication were assessed.Results: Postoperative evaluation was done at 42.8 months and 84.5 months in patients groups 1 and 2, respectively. All the electrodiagnostic parameters and symptoms showed improvement postoperatively in both groups of patients (p＜0.05), but showed no significant difference between the two groups (p＞0.05). Conclusion: To relieve the carpal tunnel syndrome in diabetic patients, as in non diabetic patients, surgical release of carpal tunnel would be considered positively. (J Korean Acad Rehab Med 2005; 29: 70-75)

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Ultrasonographic Study of Median Nerve after Carpal Tunnel Release.: Yoon, Joon Shik , Kim, Sei Joo , Park, Eun Mi; J Korean Acad Rehabil Med 2002;26(2):172-176.

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Objective: To assess the median nerve compression with ultrasonography before and after the carpal tunnel release and to assess the correlation between electrophysiologic findings and ultrasonographic findings of the median nerve.

Method: We studied 50 hands of 29 patients diagnosed as carpal tunnel syndrome electrophysiologically and 20 hands of 19 asymptomatic controls. We evaluated the flattening ratio and compression ratio through the short axis and long axis of the median nerve by ultrasonography before carpal tunnel release, 2 weeks and 3 months after release. The correlation of the

improvement between the eletrophysiologic findings and compression ratio was analyzed.

Results: The compression ratio of the median nerve was decreased significantly after carpal tunnel release, compared with that before release. The decrease of the compression ratio correlated with the improvement of the electrophysiologic findings significantly.

Conclusion: The ultrasonography is useful to follow up the median nerve after carpal tunnel release. (J Korean Acad Rehab Med 2002; 26: 172-176)