Akkurt Mehmet Orçun, Düzgün Serdar, Ateş Ahmet, Yaradılmış Yüksel Uğur
Department of Orthopedics and Traumatology, Yıldırım Beyazıt University, Yenimahalle Training and Research Hospital, Ankara, Turkey.
Jt Dis Relat Surg. 2020;31(1):50-5. doi: 10.5606/ehc.2020.71250.
This study aims to describe a retrospective study using prospectively gathered data to compare mini-open and extended open release techniques for moderate to severe carpal tunnel syndrome (CTS).
The data of 198 consecutive patients (139 males, 59 females; mean age 57.0±4.5 years; range, 44 to 75 years) treated for CPS were used. For matching, age, gender and severity of the compression, the Greathouse Ernst Halle Schaffer neurophysiological classification system was used. After matching, 63 observations in each group (group 1: mini-open and group 2: extended open) were used for analysis. A Jamar hydraulic hand dynamometer was used to measure pre- and postoperative third month grip strengths. The key pinch test was performed also at third month. Patients completed the Boston Carpal Tunnel Questionnaire at the last follow-up.
Symptom severity and functional status were improved up to half fold in both groups at final follow-up; however, there was no statistically significant clinical difference between the groups (p>0.05). There were totally six patients with paresthesia symptoms (three in each group; 4.7%), which improved in three months. Eight patients (6.3%, one in group 1 and seven in group 2, p=0.032) had dysesthesia and pillar pain.
Mini-open and extended open carpal tunnel release have similar clinical outcomes without any major complications.
本研究旨在描述一项回顾性研究，该研究使用前瞻性收集的数据，比较中度至重度腕管综合征（CTS）的微创开放和扩大开放减压技术。
使用198例连续接受CPS治疗患者的数据（男性139例，女性59例；平均年龄57.0±4.5岁；范围44至75岁）。为了匹配年龄、性别和压迫严重程度，使用了Greathouse Ernst Halle Schaffer神经生理分类系统。匹配后，每组63例观察对象（第1组：微创开放；第2组：扩大开放）用于分析。使用Jamar液压式握力计测量术前和术后第三个月的握力。在第三个月也进行了关键捏力测试。患者在最后一次随访时完成波士顿腕管综合征问卷。
在最后一次随访时，两组患者的症状严重程度和功能状态均改善了近一半；然而，两组之间在临床上无统计学显著差异（p>0.05）。共有6例患者出现感觉异常症状（每组3例；4.7%），在三个月内有所改善。8例患者（6.3%，第1组1例，第2组7例，p=0.032）出现感觉障碍和柱状疼痛。
微创开放和扩大开放腕管减压术具有相似的临床效果，且无任何重大并发症。
