Mardanpour Keykhosro, Rahbar Mahtab, Mardanpour Sourena
Department of Orthopedic, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Department of Pathologic, Iran University of Medical Sciences, Tehran, Iran.
Asian J Neurosurg. 2019 Jul-Sep;14(3):693-697. doi: 10.4103/ajns.AJNS_31_17.
There is an opportunity for median nerve decompression by open surgery in carpal tunnel syndrome which is the most common surgical procedure in neurosurgical practice. The aim of this study is to evaluate the long-term outcomes of carpal tunnel release with 1.5 cm longitudinal mini-incision technique with regarding the effectiveness and safety.
For this prospective study, 300 hands for 188 patients with advanced carpal tunnel syndrome who had indication for neurolysis underwent carpal tunnel release through a 1.5 cm longitudinal mini-incision between March 2011 and 2015. There were 132 (70%) females and 56 (30%) males with a mean age of 40 ± 29.5 years (ranging from 24 to 73) and female to male: About 2.56.178 operations were performed for the right hand and 122 for the left hand. Preoperatively, all patients were evaluated with clinical examination and nerve conduction studies. The clinical effects of the patients assessed with the Global Symptom Score (GSS) and Visual Analog Patient Satisfaction Scale.
The mean follow-up period was 18.6 ± 9.3 months (12-30 months). Postoperatively, 2% (six hands) complained of residual mild pain with tenderness of scar and only 1% (three hands) complained of median nerve damage (neuropraxy) with tingling and numbness but was temporary which improved after 1 week. Five patients (seven hands) loosed strength of their wrists, but muscle force of abductor pollicis brevis reinforced after 1 month. There is no evidence of local infection, stiffness, loss of some wrist strength, or recurrence of the disorder. Postoperative GSS scoring obviously improved than preoperative ( < 0.002). There is no patient who underwent reoperation. The mean time recovery appeared almost 2 weeks.
1.5 cm longitudinal mini-incision method in carpal tunnel syndrome decompression showed satisfactory pain relief, wound healing, and nontender scar with good functional outcomes. The technique was performed safely without major complication.
在腕管综合征中，通过开放手术进行正中神经减压是神经外科实践中最常见的外科手术。本研究的目的是评估采用1.5厘米纵向小切口技术进行腕管松解术的长期疗效及安全性。
在这项前瞻性研究中，2011年3月至2015年期间，对188例有神经松解指征的晚期腕管综合征患者的300只手，通过1.5厘米纵向小切口进行腕管松解术。其中女性132例（70%），男性56例（30%），平均年龄40±29.5岁（24至73岁），女性与男性比例约为2.56:1。右手手术178例，左手手术122例。术前，所有患者均接受临床检查和神经传导研究。采用全球症状评分（GSS）和视觉模拟患者满意度量表评估患者的临床效果。
平均随访期为18.6±9.3个月（12至30个月）。术后，2%（6只手）抱怨有残留轻度疼痛伴瘢痕压痛，仅1%（3只手）抱怨正中神经损伤（神经失用）伴刺痛和麻木，但为暂时性，1周后改善。5例患者（7只手）手腕力量减弱，但拇短展肌肌力在1个月后增强。无局部感染、僵硬、部分手腕力量丧失或疾病复发的证据。术后GSS评分明显优于术前（<0.002）。无患者接受再次手术。平均恢复时间约为2周。
1.5厘米纵向小切口方法用于腕管综合征减压显示出令人满意的疼痛缓解、伤口愈合及无压痛瘢痕，功能结果良好。该技术安全实施，无重大并发症。
