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Synovial flap may prevent recurrent perineural adhesions in carpal tunnel syndrome

The synovial flap may have clinical utility in preventing recurrence of perineural lesions in patients with carpal tunnel syndrome.

The researchers suggested that the synovial flap is an ideal tissue to prevent recurrence of these adhesions in this patient population, but that the process had not been adequately described.

They injected 20 fresh cadaver upper extremities with microfilm to assess several parameters, including arterial anatomy, flap dimensions and arc of rotation of the flexor tendon synovium. Analysis indicated that both radial and ulnar based flaps may have clinical utility in providing coverage in the wrist and distal forearm.

Clinicians used this flap in 18 patients who had complicated median nerve lesions in this region. An uncomplicated postoperative course was reported in all patients in the cohort. Posttraumatic median nerve neuromas occurred in 13 patients. Significant resolution was reported in 11 of those individuals.

The researchers concluded that the flexor tendon synovium adequately protects the median nerve. – by Rob Volansky

Disclosure: The researchers report no relevant financial disclosures.