Department of Traumatology, Orthopedics and Polyclinic Surgery, Samara State Medical University, 89 Chapayevskaya Str., 443099 Samara, Russian Federation.
Traumatological and Orthopedic Department, Mother & Child Samara Hospital ("IDK Hospital"), 70 Volzhskoe Highway, 443072 Samara, Russian Federation.
Hand Surg Rehabil. 2022 Sep;41(4):470-476. doi: 10.1016/j.hansur.2021.12.013. Epub 2022 May 2.
In the practice of carpal tunnel surgery, open decompression of the median nerve in carpal tunnel syndrome (CTS) is recognized as the therapeutic priority. However, the speed and completeness of postoperative recovery of sensitivity and function depend on the initial clinical manifestations of the disease and the severity of the electrophysiological disorder. The aim of this study was to investigate the influence of preoperative clinical and electrophysiological factors on the outcome of surgical treatment of patients with CTS of varying severity. One-hundred and eighty-nine open decompressions of the median nerve via a mini-open incision were performed in 161 patients with idiopathic CTS. Clinical observations were classified in 5 groups, according to severity. Treatment results were evaluated per group at 6 weeks and 3, 6 and 12 months after surgery. In all cases, there was improvement and positive dynamics according to clinical and electroneuromyographic data. Open decompression of the median nerve via mini-open incision can achieve significant clinical and functional improvement in the majority of patients with CTS. However, the most favorable results were mainly seen in patients with initial severity classified in the first, second and third (lower severity) groups.
在腕管综合征（CTS）的腕管正中神经切开减压术中，开放性减压被认为是治疗的首要选择。然而，术后感觉和功能恢复的速度和完全性取决于疾病的初始临床表现和电生理障碍的严重程度。本研究旨在探讨术前临床和电生理因素对不同严重程度 CTS 患者手术治疗效果的影响。161 例特发性 CTS 患者采用微创小切口行正中神经开放性减压术 189 例。根据严重程度将临床观察分为 5 组。术后 6 周和 3、6、12 个月分别对每组进行治疗效果评估。所有病例均根据临床和肌电图数据显示出改善和积极的动态。通过微创小切口进行正中神经开放性减压术可使大多数 CTS 患者获得显著的临床和功能改善。然而，最初严重程度分类为第一、第二和第三（较低严重程度）组的患者主要获得了更有利的结果。
