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The median nerve is a nerve in humans and other animals in the upper limb. It is one of the five main nerves originating from the brachial plexus. The median nerve originates from the lateral and medial cords of the brachial plexus, [1] and has contributions from ventral roots of C6-C7 (lateral cord) and C8 and T1 (medial cord). [1] [2]
At the 2007 meeting of the American Society for Surgery of the Hand, a former advocate of endoscopic carpal tunnel release, Thomas J. Fischer, MD, retracted his advocacy of the technique, based on his own personal assessment that the benefit of the procedure (slightly faster recovery) did not outweigh the risk of injury to the median nerve.
Nerve decompressions are still a relatively new surgery, however a picture emerges from looking at the outcomes of some of the most studied nerve decompressions: carpal tunnel release, sciatic nerve decompression, and migraine surgery. Even within these commonly performed surgeries, the measurement of outcomes is not always standardized.
The problem is difficult to address, and revision surgery is less successful than primary carpal tunnel release surgery. [43] Injury to the median nerve proper occurs in 0.06% of cases. [44] Risk of nerve injury has been found to be higher in patients undergoing endoscopic CTR compared with open, though most are temporary neurapraxias. [45]
As cutaneous nerves cover all areas of the skin, and any surgery which requires incisions may inadvertently cause injury or scarring, now entrapping a cutaneous nerve. [ 15 ] A common tradeoff when electing to a neurectomy is that numbness along the nerve distribution is expected.
The length and efficiency of recovery is depended on the regenerative process that may require 6 to 18 months. The length of the nerve and site of the injury influences the recovery time. To avoid tension during recovery (generally 10–14 days), minimizing movement of the nerve may reduce risk of further damage. [1]
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