Roh Young Hak, Lee Beom Koo, Noh Jung Ho, Oh Joo Han, Gong Hyun Sik, Baek Goo Hyun
Department of Orthopaedic Surgery, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea.
Department of Orthopaedic Surgery, Kangwon National University Hospital, Gangwon-do, Korea.
J Hand Surg Am. 2015 Jul;40(7):1303-9. doi: 10.1016/j.jhsa.2015.04.003. Epub 2015 May 13.
To compare outcomes of carpal tunnel release in patients with or without metabolic syndrome.
In a prospective consecutive series, 35 patients with metabolic syndrome and surgically treated carpal tunnel syndrome (CTS) were age- and sex- matched with 37 control patients without metabolic syndrome. Grip, pinch strength, perception of touch with Semmes-Weinstein monofilament, and Boston Carpal Tunnel Questionnaires (BCTQ) were assessed preoperatively and at 3, 6, and 12 months postoperatively.
Patients with metabolic syndrome had more severe electrophysiologic grade of CTS than those without metabolic syndrome, but the 2 groups had similar preoperative grip/pinch strength and BCTQ scores. The BCTQ symptom score for the metabolic syndrome group was significantly greater than that of the control group at 3 months, and the BCTQ function score of the metabolic syndrome group was significantly greater than that of the control group at 3 and 6 months' follow-up. However, there was no significant difference in BCTQ symptom or functional scores between groups at 12 months' follow-up. There was no significant difference in grip strength between groups through 12 months' follow-up whereas the pinch strength of the control group was significantly greater than that of the metabolic syndrome group at 12 months' follow-up. Semmes-Weinstein monofilament test results were significantly greater in the control group than in the metabolic syndrome group at 3 and 6 months' follow-up but were similar at 12 months.
Patients with CTS and metabolic syndrome have delayed functional recovery after carpal tunnel release, but noteworthy improvements in symptom severity and hand function are similar to those in patients without metabolic syndrome 1 year after surgery.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.
比较患有或未患有代谢综合征的患者在腕管松解术后的疗效。
在一项前瞻性连续系列研究中，35例患有代谢综合征且接受手术治疗腕管综合征（CTS）的患者在年龄和性别上与37例无代谢综合征的对照患者相匹配。术前以及术后3个月、6个月和12个月时评估握力、捏力、用Semmes-Weinstein单丝触觉感知以及波士顿腕管问卷（BCTQ）。
患有代谢综合征的患者CTS的电生理分级比未患代谢综合征的患者更严重，但两组术前的握力/捏力和BCTQ评分相似。代谢综合征组的BCTQ症状评分在术后3个月时显著高于对照组，代谢综合征组的BCTQ功能评分在随访3个月和6个月时显著高于对照组。然而，在随访12个月时，两组之间的BCTQ症状或功能评分没有显著差异。在12个月的随访期间，两组之间的握力没有显著差异，而在随访12个月时，对照组的捏力显著大于代谢综合征组。在随访3个月和6个月时，对照组的Semmes-Weinstein单丝测试结果显著高于代谢综合征组，但在12个月时相似。
患有CTS和代谢综合征的患者在腕管松解术后功能恢复延迟，但值得注意的是，术后1年症状严重程度和手部功能的改善与无代谢综合征的患者相似。
研究类型/证据水平：预后性II级。
