Persistent carpal tunnel syndrome after both endoscopic and open release: a rare case of a bifid median nerve in two separate compartments

We present a case of carpal tunnel syndrome in the presence of a bifid median nerve. The symptoms had not been relieved by two previous operations to decompress the median nerve, one endoscopic and one open. At the third operation the second half of the nerve was found in its own tunnel, and released. The literature on variations in the median nerve is reviewed. Open release is indicated in recurrent carpal tunnel syndrome and where anatomical variations are suspected.