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小切口腕管松解术的功能结局

The Functional Outcome of Mini Carpal Tunnel Release.

作者信息

Anbarasan Amaleswaran, Thevarajah Nahulan, Sadagatullah Abdul Nawfar

机构信息

Department of Orthopaedics, Queen Elizabeth Hospital II, Kota Kinabalu, Malaysia.

Department of Orthopaedics, Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia.

出版信息

J Hand Microsurg. 2017 Apr;9(1):6-10. doi: 10.1055/s-0037-1598089. Epub 2017 Jan 31.

Abstract

Carpal tunnel syndrome (CTS) is one of the most common compression neuropathies in the upper limbs and requires surgery if conservative treatment fails. This study assessed the functional outcome of vertical mini carpal tunnel release (CTR) at distal wrist crease.  To evaluate prospectively the safety, effectiveness, and reproducibility of vertical mini-open blind technique for CTR.  In total, 36 patients (40 hands) aged between 22 and 71 years with mild to moderate CTS based on nerve conduction studies were selected and screened based on inclusion and exclusion criteria. The surgery was done with vertical mini-incision CTR at distal wrist crease. The preoperative and postoperative clinical outcomes and grip strength were evaluated with Levine-Katz questionnaire and JAMAR Hydraulic Hand Dynamometer with 3 months follow-up after surgery.  The mean score for both symptom severity and functional status reduced and mean handgrip strength improved 29.5% at 3 months after surgery. All the patients were satisfied with the cosmetic outcome of the scar. Three patients had scar tenderness. All patients were able to return to work within 4 weeks after surgery, except one who developed chronic regional pain syndrome.  The vertical mini-open blind technique has been shown to be safe and easily reproducible and has short recovery period. All patients return to good functional status 3 months postoperative.

摘要

腕管综合征(CTS)是上肢最常见的压迫性神经病变之一,若保守治疗失败则需进行手术。本研究评估了在腕部远侧横纹处进行垂直小切口腕管松解术(CTR)的功能结局。 前瞻性评估垂直小切口盲视技术用于腕管松解术的安全性、有效性和可重复性。 总共选择了36例年龄在22至71岁之间、根据神经传导研究诊断为轻至中度腕管综合征的患者(40只手),并根据纳入和排除标准进行筛选。手术在腕部远侧横纹处采用垂直小切口腕管松解术进行。术前和术后的临床结局及握力通过Levine-Katz问卷和JAMAR液压式握力计进行评估,术后随访3个月。 术后3个月时,症状严重程度和功能状态的平均评分均降低,平均握力提高了29.5%。所有患者对瘢痕的美容效果均满意。3例患者有瘢痕压痛。除1例发生慢性区域疼痛综合征的患者外,所有患者均能在术后4周内恢复工作。 垂直小切口盲视技术已被证明是安全的、易于重复操作的,且恢复期短。所有患者术后3个月均恢复到良好的功能状态。

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