Background: Carpal tunnel syndrome, the most common peripheral neuropathy, results from compression of the median nerve at the wrist. Unfortunately, persistence of symptoms or recurrence of carpal tunnel syndrome is frequent after surgical decompression. In such cases, the median nerve needs to be covered with a vascularized tissue to prevent recurrence of the adhesions. Local muscle or fat flaps like the abductor digiti minimi, pronator quadratus, palmaris brevis and hypothenar fat flap can be used after neurolysis to cover the median nerve.
Methods: This study was carried out between May 2015 and September 2016 over 20 patients. The patients were classified into two groups according to the type of the flap coverage of the median nerve [in a random pattern]. The hypothenar fat pad flap was used to cover the median nerve in 10 patients in group A. In group B, local muscle flaps were used in another 10 patients [the abductor digiti minimi muscle flap was used in 6 while the palmaris brevis muscle flap was used in 4 patients].
Results: The mean motor nerve latency postoperatively was 4.28 ms ± 0.85 and 3.97 ms ± 0.68 in group A and group B respectively. The mean sensory nerve latency postoperatively was 3.27 ms ± 0.84 and 3.05 ms ± 0.80 in group A and group B respectively. When comparing the postoperative mean motor nerve latency of the median nerve of the operated hands in both groups and also the postoperative mean sensory nerve latency in them; the P-value of t-test for them was 0.381 and 0.544 respectively [>0.05].
Conclusion: There is no statistically significant difference between both types of flaps regarding the results of the postoperative nerve conduction studies and subsidence of the symptoms and signs of the patients.