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腕管松解术后腕弓增宽及疗效评估

Evaluation of Carpal Arch Widening and Outcomes After Carpal Tunnel Release.

作者信息

Kwon Yong Eok, Gong Hyun Sik, Shin Han Sol, Lee Hyung Rae, Kim Ka Hyun, Baek Goo Hyun

机构信息

Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea.

Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea.

出版信息

J Hand Surg Am. 2017 Feb;42(2):113-117. doi: 10.1016/j.jhsa.2016.11.030.

Abstract

PURPOSE

The purpose of this study was to compare the carpal arch widths between baseline and 6 months after open carpal tunnel release, and to determine whether any increase in the carpal arch width was associated with clinical outcomes of surgery.

METHODS

We measured carpal arch widths in standardized carpal tunnel radiographs before, and 6 months after, open carpal tunnel release in 76 patients with carpal tunnel syndrome. Clinical outcomes were assessed for grip strength change and perceived disability using the Disabilities of the Arm, Shoulder, and Hand questionnaire at 6-month follow-up. We correlated the clinical outcomes with carpal arch width changes.

RESULTS

The mean change of the carpal arch width was 1.8 mm (standard deviation, 1.4 mm; range, -0.3 to 5.2 mm). There was no significant correlation between the amount of carpal arch width widening and the clinical outcomes in terms of grip strength change and the Disabilities of the Arm, Shoulder, and Hand scores.

CONCLUSIONS

This study found that the change of carpal arch width was minimal at 6 months after open carpal tunnel release, and that the increase, if any, was not associated with clinical outcomes such as grip strength change or the Disabilities of the Arm, Shoulder, and Hand scores.

TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.

摘要

目的

本研究旨在比较开放性腕管松解术前及术后6个月时腕管弓宽度,并确定腕管弓宽度的任何增加是否与手术的临床结果相关。

方法

我们在76例腕管综合征患者开放性腕管松解术前及术后6个月,测量标准化腕管X线片上的腕管弓宽度。在6个月随访时,使用手臂、肩部和手部功能障碍问卷评估握力变化和感知残疾情况等临床结果。我们将临床结果与腕管弓宽度变化进行关联分析。

结果

腕管弓宽度的平均变化为1.8毫米(标准差为1.4毫米;范围为-0.3至5.2毫米)。就握力变化和手臂、肩部和手部功能障碍评分而言,腕管弓宽度增加量与临床结果之间无显著相关性。

结论

本研究发现,开放性腕管松解术后6个月时腕管弓宽度变化极小,且即便有增加,也与握力变化或手臂、肩部和手部功能障碍评分等临床结果无关。

研究类型/证据水平:预后性IV级。

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