Vascularised tissue for coverage of the median nerve after surgery for persistant or recurrent carpal tunnel syndrome can be a challenging problem. Persistence of median nerve symptoms is consistent with incomplete decompression[1]. Recurrence is documented carpal tunnel syndrome where there was an initially resolution of symptoms following initial decompression[2]. Persistence and recurrence of symptoms may be of differing aetiologies but all must be considered in the management of this difficult problem.
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