Huemer Georg M, Koller Matthias, Pachinger Thomas, Dunst Karin M, Schwarz Barbara, Hintringer Thomas
Department of Plastic Surgery, Sisters of Mercy Hospital, Seilerstaette 4, 4020, Linz, Austria.
Muscle Nerve. 2007 Oct;36(4):528-31. doi: 10.1002/mus.20839.
Although surgical division of the transverse carpal ligament is the operative treatment of choice for carpal tunnel syndrome (CTS), controversy exists about the immediate postoperative treatment regimen. Splinting for up to 6 weeks after surgery is recommended by some investigators. We therefore evaluated effectiveness of splinting after open carpal tunnel surgery by a randomized, controlled trial. Fifty consecutive patients with clinically and electrophysiologically confirmed idiopathic CTS were assigned to open carpal tunnel release and randomized to receiving a light bandage (25 patients) or a bulky dressing with a volar splint (25 patients) for 2 days each. All patients were followed up at 3 months. Parameters retrieved were pain as measured using a visual analog scale, two-point discrimination, and grip strength, and nerve conduction studies. At follow-up, all patients reported definite improvement of symptoms, but there was no statistically significant difference between the two groups for any of our outcome measures. Thus, postoperative splinting after open carpal tunnel release does not yield any benefit to eventual outcome. In fact, it adds to the overall operating time and can safely be abandoned.
尽管横腕韧带手术切开是腕管综合征（CTS）的首选手术治疗方法，但术后即刻治疗方案仍存在争议。一些研究者建议术后使用夹板固定长达6周。因此，我们通过一项随机对照试验评估了开放性腕管手术后使用夹板的效果。连续50例临床和电生理确诊的特发性CTS患者接受开放性腕管松解术，并随机分为两组，每组25例，一组接受轻质绷带包扎，另一组接受带掌侧夹板的厚敷料包扎，各持续2天。所有患者均在3个月时进行随访。获取的参数包括使用视觉模拟量表测量的疼痛、两点辨别觉、握力以及神经传导研究。随访时，所有患者均报告症状有明显改善，但两组在任何一项结局指标上均无统计学显著差异。因此，开放性腕管松解术后的术后夹板固定对最终结局并无益处。事实上，它增加了总体手术时间，可以安全地摒弃。
