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复发性腕管综合征:可能病因的评估与治疗

Recurrent carpal tunnel syndrome: Evaluation and treatment of the possible causes.

作者信息

Eroğlu Ahmet, Sarı Enes, Topuz Ali Kıvanç, Şimşek Hakan, Pusat Serhat

机构信息

Department of Neurosurgery, Haydarpaşa Sultan Abdülhamid Education and Research Hospital, Istanbul 34000, Turkey.

Department of Orthopaedics and Traumatology, Near East University Hospital, Lefkoşa 99010, Cyprus.

出版信息

World J Clin Cases. 2018 Sep 26;6(10):365-372. doi: 10.12998/wjcc.v6.i10.365.

Abstract

AIM

To investigate the causes of the recurrent carpal tunnel syndrome (CTS) and implemented surgical interventions.

METHODS

Four hundred and eighty-seven patients, who were diagnosed with CTS and underwent surgical intervention between October 2016 and September 2007, were evaluated in this retrospective study. The age, gender, physical evaluation findings, electrophysiological examination reports and implemented surgical treatment methods were analyzed.

RESULTS

Thirty-nine of the cases were operated due to recurrent CTS. Further examination of the patients with recurrent CTS revealed that ten cases had diabetic polyneuropathy, three cases had hypothyroidism, two cases had rheumatoid arthritis and one case had systemic amyloidosis. Postoperative electromyography confirmed the neuropathy was due to systemic diseases. The remaining 23 patients with recurrent CTS did not have any systemic disease and all of them had applied previously to another health center.

CONCLUSION

We concluded that the recurrence rates in CTS might be decreased with exploration and incision of the entire transverse ligament. Damage to the motor and sensory branches of the median nerve could be avoided with an incision on the ulnar side.

摘要

目的

探讨复发性腕管综合征(CTS)的病因并实施手术干预。

方法

本回顾性研究评估了2007年10月至2016年9月期间被诊断为CTS并接受手术干预的487例患者。分析了年龄、性别、体格检查结果、电生理检查报告及实施的手术治疗方法。

结果

39例因复发性CTS接受手术。对复发性CTS患者的进一步检查发现,10例患有糖尿病性多发性神经病,3例患有甲状腺功能减退症,2例患有类风湿性关节炎,1例患有系统性淀粉样变性。术后肌电图证实神经病变是由全身性疾病引起的。其余23例复发性CTS患者没有任何全身性疾病,且他们都曾就诊于另一家医疗中心。

结论

我们得出结论,通过探查和切开整个横韧带,CTS的复发率可能会降低。尺侧切口可避免正中神经运动和感觉分支受损。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/044f/6163139/a8b40f672ed6/WJCC-6-365-g001.jpg

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