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IJMDC. 2023; 7(4): 742-744

Hypothenar fat pad flap to prevent ecurrence of carpal tunnel syndrome: a case report

Hani A. Shash, Abdulrahman A. Alghamdi, Hayam A. Shash, Sawsan F. Almarzouq.


Background: Carpal tunnel syndrome (CTS) is one of the most prevalent peripheral neuropathies and most commonly affects middle-aged women. The typical symptoms of CTS are nocturnal pain accompanied by tingling and numbness in the hand’s median nerve distribution. The management of CTS ranges from conservative treatment to surgical intervention with good response. However, the recurrence of CTS after the first surgery can reach up to 25%, and up to 95% after the second one.
Case Presentation: We report a 41-year-old woman with a Schwannoma of her right median nerve with CTS. She developed a recurrence of the symptoms despite traditional surgical correction three times. The plan is to do an alternative surgical procedure, the hypothenar fat pad flap (HTFPF), particularly due to the neuroma aiming to cover the affected nerve with fat and prevent further recurrence. The surgery was successful, and the patient’s symptoms subsided with no further recurrences.
Conclusion: The HTFPF is an excellent surgical choice for recurrent CTS, and the choice of surgery in these cases should be individualized according to the patient clinical condition.

Key words: Carpal Tunnel Syndrome; recurrent carpal tunnel syndrome; hypothenar fat pad flap; median nerve

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