Fehringer Edward V, Tiedeman Jeffrey J, Dobler Kristyn, McCarthy Jack A
Bergan Mercy Medical Center, the University of Nebraska Medical Center, Omaha, Nebraska, USA.
Arthroscopy. 2002 Mar;18(3):316-21. doi: 10.1053/jars.2002.30643.
Open and endoscopic carpal tunnel release techniques have achieved excellent results for treatment of carpal tunnel syndrome. Symptoms frequently occur bilaterally but there are no reports of simultaneous operative intervention. The purpose of this study was to evaluate results in patients who underwent staged bilateral endoscopic carpal tunnel releases and in those who underwent simultaneous bilateral releases.
Retrospective review.
The efficacy of simultaneous and staged bilateral endoscopic carpal tunnel releases was evaluated using a retrospective chart review. This included patients who underwent these procedures during a 48-month period. Group A (48 patients) underwent staged procedures; group group B (48 patients) underwent simultaneous procedures. Inclusion criteria were a positive history and physical examination, positive electrical studies, and failure of conservative measures. Single-incision endoscopic releases were performed on an outpatient basis. Early rehabilitation with intermittent splinting was utilized. The analysis included complications, satisfaction, return to work, physician visits, physical therapy sessions, days to maximum medical improvement for all, and average percentage permanent partial impairment for Workers' Compensation patients.
A decrease in return to work at regular duty was noted in the simultaneous group compared with the staged group for patients who had not filed Workers' Compensation claims (P =.0158). The simultaneous group had fewer physician visits than the staged group (P =.0002). Overall patient satisfaction was equal.
Simultaneous bilateral endoscopic carpal tunnel releases are well tolerated with mild restrictions and a decrease in cost.
开放性和内镜下腕管松解技术在治疗腕管综合征方面均取得了优异的效果。症状常双侧出现，但尚无同时进行手术干预的报道。本研究的目的是评估分期双侧内镜下腕管松解术患者以及同期双侧松解术患者的治疗结果。
回顾性研究。
通过回顾性病历审查评估同期和分期双侧内镜下腕管松解术的疗效。研究对象为在48个月期间接受这些手术的患者。A组（48例患者）接受分期手术；B组（48例患者）接受同期手术。纳入标准为有阳性病史及体格检查、电生理检查阳性以及保守治疗无效。单切口内镜松解术在门诊进行。采用间歇性夹板固定进行早期康复治疗。分析内容包括并发症、满意度、重返工作岗位情况、医生诊疗次数、物理治疗疗程、所有人达到最大医学改善的天数以及工伤赔偿患者的永久性部分损伤平均百分比。
对于未提出工伤赔偿申请的患者，同期组与分期组相比，正常工作的重返率有所下降（P = 0.0158）。同期组的医生诊疗次数少于分期组（P = 0.0002）。总体患者满意度相当。
同期双侧内镜下腕管松解术耐受性良好，限制轻微且成本降低。
