Oropeza-Duarte César, Ramos-Maciel Joel, Naranjo-Hernández Juan Daniel, Villarreal-Salgado José Luis, Torres-Salazar Quitzia Libertad
Institute of Safety and Social Services of State Workers, Hospital Dr. Valentin Gomez Farias, General Surgery Department, Mexico.
Institute of Scientific Research "Alpha 0.01", Durango, Durango, Mexico.
Int J Surg Case Rep. 2021 Nov;88:106501. doi: 10.1016/j.ijscr.2021.106501. Epub 2021 Oct 25.
Carpal tunnel syndrome has attracted attention as an occupational disease due to the dramatic increase on its magnitude, and its prevalence in the general population, who's has been reported from a 0.6 to 3.4%. Currently, there are various techniques for its approach. However, there is great controversy when it comes to establishing which of the methods is the most beneficial. The objective of this study was to compare the efficacy of the mini-transverse incision against the traditional longitudinal technique in treatment of carpal tunnel syndrome.
A series of cases is presented, prospectively included, of patients with a diagnosis of carpal tunnel syndrome, who are beneficiaries of a government hospital. We present a series of cases with a diagnosis of carpal tunnel syndrome, which were performed with two different techniques. Both techniques were evaluated by comparing the recovery and work reintegration times, as well as the decrease in pain and the absence of complications.
A total of 8 patients operated with a minimal incision and 9 with a traditional reduced incision were studied. Significant differences were shown in the days taken to return to work, with a median of 17.5 (q25-q75 14-21) days for mini-transverse incision group and of 28 (q25-q75 21-28) days for the longitudinal traditional incision group (p = 0.002). Likewise, differences were obtained in the visual analogue pain scale during the first week of evaluation 4 vs 7 (p = 0.000), in contrast to complications where there were no differences at all.
The results obtained corroborate a greater efficacy of the mini-transverse incision technique, in reducing disability times. This favors the health institution to reduce the costs of rehabilitation and for the patient to have a prompt work reintegration. It is suggested to strengthen the scientific evidence that supports the use of this technique by exploring other areas such as functional status or long-term benefits.
腕管综合征因其发病率急剧上升以及在普通人群中的患病率(据报道为0.6%至3.4%)而作为一种职业病受到关注。目前,有多种治疗方法。然而,在确定哪种方法最有益时存在很大争议。本研究的目的是比较小横切口与传统纵切口技术治疗腕管综合征的疗效。
前瞻性纳入了一系列诊断为腕管综合征的病例,这些患者均为一家政府医院的受益者。我们展示了一系列采用两种不同技术治疗腕管综合征的病例。通过比较恢复和重返工作时间、疼痛减轻情况以及有无并发症来评估这两种技术。
共研究了8例采用最小切口手术的患者和9例采用传统缩小切口手术的患者。在重返工作所需天数上显示出显著差异,小横切口组中位数为17.5天(四分位数间距为14 - 21天),传统纵切口组为28天(四分位数间距为21 - 28天)(p = 0.002)。同样,在评估第一周的视觉模拟疼痛量表上也有差异,分别为4分和7分(p = 0.000),而并发症方面则没有差异。
所获得的结果证实了小横切口技术在减少残疾时间方面具有更高的疗效。这有利于医疗机构降低康复成本,也有利于患者迅速重返工作岗位。建议通过探索其他领域,如功能状态或长期益处,来加强支持使用该技术的科学证据。