Martínez-Catasús A, Lobo-Escolar L, García-Bonet J, Corrales-Rodríguez M, Pasarín-Martínez A, Berlanga-de-Mingo D
Department of Orthopaedics and Traumatology Surgery, Hospital San Rafael, Barcelona, Spain.
Department of Orthopaedics and Traumatology Surgery, Hospital San Rafael, Barcelona, Spain; Department of Orthopaedics and Traumatology Surgery, Hospital ASEPEYO San Cugat, Barcelona, Spain; Autonomous University of Barcelona, Barcelona, Spain.
Hand Surg Rehabil. 2019 Jun;38(3):202-206. doi: 10.1016/j.hansur.2019.02.003. Epub 2019 Mar 2.
Given the controversy about the best surgical technique for carpal tunnel release, this study tested the hypothesis that no significant differences would be observed between single-portal endoscopic release and a short, 1-cm incision open release in a large sample of patients. Consecutive patients were assigned to one of the two techniques. Preoperative and postoperative measurements included grip and pinch strength, a visual analog scale for pain and a satisfaction questionnaire. Eighty-seven patients completed the study: 35 with an endoscopic release and 52 with an open release. Both techniques were effective and safe: grip and pinch strength decreased 1 month after surgery in both techniques but improved significantly at 6 and 12 months (P < 0.05) while the complication rate was low. Subjective results were judged to be "excellent or good" by more than 90% of patients in both groups. No significant between-technique differences in outcomes were observed thus, surgical decisions may be based on criteria other than effectiveness. LEVEL OF EVIDENCE: Level IV; Case Series; Treatment Study.
鉴于腕管松解术的最佳手术技术存在争议，本研究检验了这样一个假设：在大量患者样本中，单通道内镜松解术与1厘米短切口开放松解术之间不会观察到显著差异。连续的患者被分配到两种技术中的一种。术前和术后测量包括握力和捏力、疼痛视觉模拟量表和满意度问卷。87名患者完成了研究：35例行内镜松解术，52例行开放松解术。两种技术均有效且安全：两种技术术后1个月握力和捏力均下降，但在6个月和12个月时显著改善（P < 0.05），并发症发生率较低。两组中超过90%的患者主观结果被判定为“优秀或良好”。因此，未观察到两种技术在结果上的显著差异，手术决策可以基于有效性以外的标准。证据级别：四级；病例系列；治疗研究。
