Malhotra R, Kiran E Krishna, Dua Aman, Mallinath S G, Bhan S
Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, India.
Indian J Orthop. 2007 Jan;41(1):57-61. doi: 10.4103/0019-5413.30527.
To compare the results of endoscopic carpal tunnel release (CTR) with open CTR in patients with idiopathic Carpal tunnel syndrome (CTS).
Seventy-one patients with CTS were enrolled in a prospective randomized study from May 2003 to December 2005. All patients had clinical signs or symptoms and electro-diagnostic findings consistent with carpal tunnel syndrome and had not responded to nonoperative management. Sixty-one cases were available for follow-up. Endoscopic CTR was performed in 30 CTS patients and open CTR was performed in 31 wrists (30 patients). Various parameters were evaluated, including each patient's symptom amelioration, complications, operation time, time needed to resume normal lifestyle and the frequency of revision surgery. All the patients were followed up for six months.
During the initial months after surgery, the patients treated with the endoscopic method were better symptomatically and functionally. Local wound problems in terms of scarring or scar tenderness were significantly more pronounced in patients undergoing open CTR compared to patients undergoing endoscopic CTR. Average delay to return to normal activity was appreciably less in group undergoing endoscopic CTR. No significant difference was observed between the endoscopic CTR group and open CTR group in regard to symptom amelioration, electromyographic testing and complications at the end of six months.
Short-term results were better with the endoscopic method as there was no scar tenderness. Results at six months were comparable in both groups.
比较特发性腕管综合征(CTS)患者接受内镜下腕管松解术(CTR)与开放性CTR的结果。
2003年5月至2005年12月,71例CTS患者纳入一项前瞻性随机研究。所有患者均有与腕管综合征相符的临床体征或症状以及电诊断结果,且对非手术治疗无反应。61例可供随访。30例CTS患者接受内镜下CTR,31例手腕(30例患者)接受开放性CTR。评估了各种参数,包括每位患者的症状改善情况、并发症、手术时间、恢复正常生活方式所需时间以及翻修手术频率。所有患者均随访6个月。
在术后最初几个月,接受内镜治疗的患者在症状和功能方面更好。与接受内镜下CTR的患者相比,接受开放性CTR的患者在瘢痕形成或瘢痕压痛方面的局部伤口问题明显更突出。接受内镜下CTR的组恢复正常活动的平均延迟明显更少。内镜下CTR组与开放性CTR组在6个月末的症状改善、肌电图检查和并发症方面未观察到显著差异。
内镜治疗的短期效果更好,因为没有瘢痕压痛。两组6个月时的结果相当。