Department of Orthopaedics Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
PLoS One. 2019 Jan 28;14(1):e0211369. doi: 10.1371/journal.pone.0211369. eCollection 2019.
Carpal tunnel syndrome is a common neuropathy disorder for which surgical treatment consists of release and reconstruction of the flexor retinaculum. Reports of postoperative clinical outcomes after carpal tunnel release with or without flexor retinaculum reconstruction in several studies are controversial. This meta-analysis aimed to compare the efficacy and safety of carpal tunnel release with or without flexor retinaculum reconstruction.
The PubMed, EMBASE, Web of Science, Ovid, Cochrane Library and Clinical Tri Org databases were searched for randomized controlled trials that compared carpal release with and without transverse carpal ligament reconstruction for carpal tunnel syndrome. Outcomes included postoperative Boston Carpal Tunnel Questionnaire Symptom Severity Scale (SSS), Functional Status Scale (FSS), grip strength and complications. The follow-up time was categorized into short-term (0-3mon) and long-term(>3mon).
A total of 7 studies with 613 patients met the inclusion criteria and were analyzed in detail. Statistical analysis showed no significant difference between two groups on postoperative long-term grip strength (MD 5.85, 95% CI -1.05 to 12.76) long-term SSS (MD -0.31, 95% CI -0.75 to 0.13) and occurrence of complications (RR 1.14, 95% CI 0.84 to 1.54), whereas statistically significant difference was found between groups regarding short-term grip strength (MD 1.51, 95% CI 0.86 to 2.17) and long-term FSS (MD -0.34, 95% CI -0.47 to -0.21).
Carpal tunnel release with flexor retinaculum reconstruction for carpal tunnel syndrome may result in improved long-term functional status while there's no advantage regarding grip strength, symptom severity and safety over individual carpal tunnel release in short- and long-term outcomes.
腕管综合征是一种常见的周围神经病变，其手术治疗包括切开并重建屈肌支持带。多项研究报告了腕管松解术后的临床疗效，结果存在争议，其中一些研究报告显示重建屈肌支持带优于不重建，另一些则显示两者之间无差异。本 meta 分析旨在比较伴有或不伴有屈肌支持带重建的腕管松解术的疗效和安全性。
检索 PubMed、EMBASE、Web of Science、Ovid、Cochrane 图书馆和 ClinicalTrials.gov 数据库，纳入比较腕管松解术与伴有或不伴有腕横韧带重建治疗腕管综合征的随机对照试验。主要结局指标包括术后波士顿腕管问卷症状严重程度评分（SSS）、功能状态评分（FSS）、握力和并发症。随访时间分为短期（0-3 个月）和长期（>3 个月）。
共纳入 7 项研究 613 例患者，详细分析显示，两组间术后长期握力（MD 5.85，95%CI-1.05 至 12.76）、长期 SSS（MD-0.31，95%CI-0.75 至 0.13）和并发症发生率（RR 1.14，95%CI 0.84 至 1.54）无显著差异，而短期握力（MD 1.51，95%CI 0.86 至 2.17）和长期 FSS（MD-0.34，95%CI-0.47 至-0.21）差异有统计学意义。
对于腕管综合征，与单纯腕管松解术相比，伴有屈肌支持带重建的腕管松解术可能在长期功能状态方面具有优势，但在短期和长期结果中，在握力、症状严重程度和安全性方面没有优势。
