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Abductor Digiti Minimi Flap for Vascularized Coverage Following Recurrent Carpal Tunnel Syndrome with Chronic Regional Pain Syndrome
Jesse B. Jupiter; Massachusetts General Hospital; Melissa A. Klausmeyer, MD
Massachusetts General Hospital, Harvard University, Boston, MA

Hypothesis: Carpal tunnel release is a common procedure, however a subset of patients have persistent symptoms post surgery and suffer from chronic regional pain syndrome. Interposition of well-vascularized soft tissue may be necessary to treat these patients, and the abductor digiti minimi flap may be useful in this setting.
Methods: After median nerve neurolysis, the abductor digit minimi is elevated on its proximal pedicle. The muscle is split longitudinally and rotated to provide coverage of the median nerve. This procedure was performed on 7 wrists in 6 patients.
Results: The median age was 68 years old (range 49-80). The average follow up is 2.75 years. All patients were satisfied with the procedure and would repeat it as necessary. Summary Points: The abductor digiti minimi flap is a reliable flap with minimal donor site morbidity. It provides predictable coverage and is a good option when treating recurrent carpal tunnel syndrome associated with chronic regional pain syndrome.


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