Department of Orthopaedic Surgery, University of Ioannina, Ioannina, Greece.
Arthroscopy. 2010 Jan;26(1):26-33. doi: 10.1016/j.arthro.2009.06.027. Epub 2009 Dec 4.
This study compared endoscopic carpal tunnel release with the conventional open technique with respect to short- and long-term improvements in functional and clinical outcomes.
We assessed 72 outpatients diagnosed with carpal tunnel syndrome. Of these patients, 37 underwent the endoscopic method according to Chow and 35 were assigned to the open method. Improvement in symptoms, severity, and functionality were evaluated at 2 days, 1 week, 2 weeks, and 1 year postoperatively. Changes in clinical outcomes were evaluated at 1 year postoperatively. Complications were also assessed.
Both groups showed similar improvement in all but 1 outcome 1 year after the release; increase in grip strength was significantly higher in the endoscopic group. However, the endoscopic method showed a greater improvement in symptoms and functional status compared with the open method at 2 days, 1 week, and 2 weeks postoperatively. Separate analysis of the questions referring to pain showed that the delay in improvement in the open group was because of the persistence of pain for a longer period. Paresthesias and numbness decrease immediately after the operation with comparable rates for both groups.
Endoscopic carpal tunnel release provides a faster recovery to operated patients for the first 2 weeks, with faster relief of pain and faster improvement in functional abilities. Paresthesia and numbness subside in an identical manner with the 2 techniques. At 1 year postoperatively, both open and endoscopic techniques seem to be equivalently efficient.
本研究比较了内窥镜下腕管松解术与传统开放式手术在改善功能和临床结果方面的短期和长期效果。
我们评估了 72 例被诊断为腕管综合征的门诊患者。其中 37 例患者采用 Chow 内镜方法，35 例患者采用开放式方法。在术后 2 天、1 周、2 周和 1 年评估症状、严重程度和功能的改善情况。术后 1 年评估临床结果的变化。还评估了并发症。
两组患者在除 1 项结果外，其余所有结果在释放后 1 年均有类似的改善；握力增加在内窥镜组显著更高。然而，与开放式方法相比，内窥镜方法在术后 2 天、1 周和 2 周时在症状和功能状态方面有更大的改善。对疼痛相关问题的单独分析表明，开放式组的改善延迟是由于疼痛持续时间更长。术后即刻两组的麻木和感觉异常均减轻，且减轻程度相似。
内窥镜下腕管松解术为手术患者在最初的 2 周内提供更快的恢复，更快缓解疼痛和更快改善功能能力。两种技术的麻木和感觉异常减轻情况相同。术后 1 年，开放式和内窥镜技术似乎同样有效。
