The Synovial Flap in Recurrent and Failed Carpal Tunnel Surgery

Recurrent carpal tunnel syndrome is defined by a return of numbness after a symptom-free period after surgical decompression. The most common reason for recurrent symptoms is thought to be the formation of a constrictive scar. In this event, it seems reasonable to lay a barrier about the nerve after rerelease to try to prevent recurrent scar formation. We believe this approach is also reasonable during revision surgery for iatrogenic nerve injury. In this article, we describe the indications and technique and clinical experience using a synovial flap used to cover the median nerve after revision decompression at the wrist.