Zhang Dafang, Blazar Philip, Earp Brandon E
1 Brigham and Women's Hospital, Boston, MA, USA.
2 Harvard Medical School, Boston, MA, USA.
Hand (N Y). 2019 Jul;14(4):471-476. doi: 10.1177/1558944718765226. Epub 2018 Mar 20.
The purpose of this study was to determine the rates and types of complications and secondary surgeries after mini-open carpal tunnel release. A retrospective cohort study was performed for 1,328 patients who underwent mini-open carpal tunnel release from August 2008 to July 2013. Patients were excluded for acute trauma, the index procedure being revision surgery, neoplasm, age less than 18 years, incomplete records, and postoperative follow-up less than 1 month, which yielded 904 patients who underwent 1,144 surgeries. Of 1,144 carpal tunnel releases performed, 14 (1.2%) were noted to have a complication at final follow-up, with no cases of major nerve or vessel injury. Fourteen patients (1.2%) underwent secondary surgery, including 11 cases for persistent or recurrent carpal tunnel syndrome and 3 cases for infection or hematoma. Chronic kidney disease was associated with an increased risk of complication. Diabetes mellitus, chronic kidney disease, and cervical radiculopathy were associated with an increased risk of secondary surgery. The short-term complication and secondary surgery rates of mini-open carpal tunnel release are low. Patients with diabetes mellitus, chronic kidney disease, and cervical radiculopathy should be counseled regarding risks of complication and secondary surgery.
本研究的目的是确定小切口腕管松解术后并发症及二次手术的发生率和类型。对2008年8月至2013年7月期间接受小切口腕管松解术的1328例患者进行了一项回顾性队列研究。排除因急性创伤、初次手术为翻修手术、肿瘤、年龄小于18岁、记录不完整以及术后随访时间少于1个月的患者，最终纳入904例患者，共进行了1144例手术。在1144例腕管松解术中，14例（1.2%）在最终随访时出现并发症，无重大神经或血管损伤病例。14例患者（1.2%）接受了二次手术，其中11例为持续性或复发性腕管综合征，3例为感染或血肿。慢性肾病与并发症风险增加相关。糖尿病、慢性肾病和颈椎病与二次手术风险增加相关。小切口腕管松解术的短期并发症和二次手术发生率较低。对于糖尿病、慢性肾病和颈椎病患者，应告知其并发症和二次手术的风险。
