Okamura Aldo, Guidetti Bruna Calvi, Caselli Raphael, Borracini Jonas Aparecido, Moraes Vinicius Ynoe DE, Belloti João Carlos
. Hospital Dr. Fernando Mauro Pires da Rocha (Hospital Municipal do Campo Limpo), São Paulo, SP, Brazil.
. Hospital Alvorada, Moema, São Paulo, SP, Brazil.
Acta Ortop Bras. 2018 Jan-Feb;26(1):48-53. doi: 10.1590/1413-785220182601181880.
To evaluate tendencies in the planning, diagnosis, and treatment of carpal tunnel syndrome (CTS) by Brazilian hand surgery specialists.
This cross-sectional study was performed at the 36th Brazilian Hand Surgery Congress. We prepared a questionnaire about preferences in the management of CTS, and board-certified hand surgeons that attended the congress were asked to fill out the questionnaires. A total of 174 questionnaires were analyzed.
Electromyography examination is used by most surgeons. Night splinting is the most commonly used conservative treatment option. Half of the surgeons utilized prophylactic antibiotics. Most of the interviewees conduct inpatient surgery in the operating room and prefer intravenous regional anesthesia. Most of surgeons use the standard open technique associated with proximal release of the antebrachial fascia and do not perform neurolysis. Compressive dressings are most commonly used for 7 days.
The approach to CTS among Brazilian hand surgeons with regard to pre-, intra-, and post-operatory conduct is consistent with the international literature. However, there is a need to reflect and conduct new studies on non-surgical treatment involving local corticosteroid injection, use of prophylactic antibiotics, hospital admission, and type of anesthesia in order to provide more cost-effective approach to surgical treatment for CTS. Level of Evidence V; Expert opinion.
评估巴西手外科专家在腕管综合征（CTS）的规划、诊断和治疗方面的倾向。
这项横断面研究在第36届巴西手外科学会上进行。我们准备了一份关于CTS治疗偏好的问卷，并要求参加会议的获得委员会认证的手外科医生填写问卷。共分析了174份问卷。
大多数外科医生使用肌电图检查。夜间夹板固定是最常用的保守治疗选择。一半的外科医生使用预防性抗生素。大多数受访者在手术室进行住院手术，且更喜欢静脉区域麻醉。大多数外科医生采用与前臂筋膜近端松解相关的标准开放技术，不进行神经松解。压迫性敷料最常使用7天。
巴西手外科医生在CTS术前、术中和术后处理方面的方法与国际文献一致。然而，有必要对涉及局部皮质类固醇注射、预防性抗生素的使用、住院治疗和麻醉类型的非手术治疗进行反思并开展新的研究，以便为CTS的手术治疗提供更具成本效益的方法。证据级别V；专家意见。
