The use of free fat grafts in recalcitrant carpal tunnel: a retrospective study

Abstract.

We present a retrospective study evaluating the proclaimed beneficial effect of the use of fat grafts in patients with recalcitrant carpal tunnel syndrome. Twenty-one re-decompression operations with fat grafting (group I) and 20 routine re-decompressions (group II) were assessed postoperatively with a questionnaire, physical examination, and nerve conduction studies. Both groups were improved by the operative intervention, but no significant differences were found between the two surgical techniques for postoperative severity of symptoms, threshold sensation, pain assessment, nerve conduction velocities, or patients' satisfaction with the postoperative result. Only the postoperative functional status score of the fat grafted patients revealed a trend to a significantly worse outcome. The fat grafted patients sustained more problems with a hypersensitive scar at the wrist level immediately after surgery, although on long-term review there was no significant difference in scar tenderness between the two groups. We concluded that implantation of free fat grafts has not proved to be of additional benefit in patients with recalcitrant carpal tunnel syndrome.