Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit
neurosurgery.fr
The patient came to the clinic 25-June-2006 complaining of severe
pain and numbness of the right hand after doing bilateral carpal
tunnel release 12-February-2006 elsewhere. The left hand
improved slightly, but the right progressed to deteriorate. The
patient was sent for ECS and EMG, which confirmed improvement of the
left side and deterioration of the right.
The patient was operated
for the right hand. Exploration of the wound revealed that the nerve
was not reached and the compression still persisting. Proper release
with inspection of the nerve with its motor branch were inspected.
Microscopic facilities were applied.
Comments:
1. The wound in
the right hand, despite it was too long, but it was higher that must
be, holding the suspicion, that proper release was not performed.
Several identical cases were seen and most the failures are due to
lack of decompression.
2. The surgeon in redo surgery, must be
ready to the worst scenarios and be ready to microscopic dissection,
in which it was not the case.
