Yuan Ling-Li, Yang Ming, Xu Wen-di, Zhu Xun-Bing, Han Guan-Sheng, Geng Chun-Hui, Zhang Zhong-Chuan
The Second OrthopedicWard, the Second Affiliated Hospital of Bengbu Medical College, Bengbu 233000, Anhui, China.
Zhongguo Gu Shang. 2021 Dec 25;34(12):1120-5. doi: 10.12200/j.issn.1003-0034.2021.12.006.
To investigate the efficacy of self-made arthroscopic single channel in the treatment of carpal tunnel syndrome.
Sixty patients with primary carpal tunnel syndrome treated from January 2014 to December 2019 were divided into arthroscopic group and traditional open operation group. There were 30 cases in arthroscopic group, including 12 males and 18 females, aged (47.5±4.5) years and the course of disease was (6.6±4.2) months. There were 30 cases in the traditional operation group, including 10 males and 20 females, aged (48.5±3.5) years, and the course of disease was (5.6±4.4) months. Both groups were unilateral. According to the anatomy of wrist joint and the characteristics of transverse carpal ligament and arthroscopy, the instruments including cannula, inner heart and hook knife were designed. The patients in two groups were treated with decompression of transverse carpal ligament using arthroscopy combined with self-made instruments and traditional open sergery. The incision length, operation time, intraoperative bleeding, hospitalization cost, hospitalization time and recovery time of the two groups were observed and compared. Boston Carpal Tunnel Questionnaire (BCTQ) score was used to evaluate the clinical efficacy of arthroscopy combined with self made instruments in the treatment of carpal tunnel syndrome.
Compared with the traditional group, the arthroscopic group had significant advantages in incision length, operation time, intraoperative bleeding and hospital stay, but the total cost of hospitalization was increased. The Boston score was significantly higher in the arthroscopic group than that in the traditional group at 1 month after operation, but not at 3 and 6 months after operation.
Arthroscopy combined with self-made instruments in the treatment of carpal tunnel syndrome is more reliable, minimally invasive and simplified than open surgery, but the patients should be clearly diagnosed and appropriately selected before operation to achieve satisfactory clinical effect.
探讨自制关节镜单通道在腕管综合征治疗中的疗效。
选取2014年1月至2019年12月收治的60例原发性腕管综合征患者，分为关节镜组和传统开放手术组。关节镜组30例，其中男12例，女18例，年龄（47.5±4.5）岁，病程（6.6±4.2）个月。传统手术组30例，其中男10例，女20例，年龄（48.5±3.5）岁，病程（5.6±4.4）个月。两组均为单侧病变。根据腕关节解剖结构、腕横韧带特点及关节镜情况，设计了包括套管、内芯及钩刀在内的器械。两组患者分别采用关节镜联合自制器械及传统开放手术行腕横韧带减压术。观察并比较两组的切口长度、手术时间、术中出血量、住院费用、住院时间及恢复时间。采用波士顿腕管综合征问卷（BCTQ）评分评估关节镜联合自制器械治疗腕管综合征的临床疗效。
与传统组相比，关节镜组在切口长度、手术时间、术中出血量及住院时间方面具有显著优势，但住院总费用增加。术后1个月时，关节镜组的波士顿评分显著高于传统组，但术后3个月和6个月时无差异。
关节镜联合自制器械治疗腕管综合征比开放手术更可靠、微创且操作简化，但术前应明确诊断并合理选择患者，以取得满意的临床效果。
