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社区环境中基于办公室的超声引导下腕管松解术:长期结果

Office-Based Carpal Tunnel Release Using Ultrasound Guidance in a Community Setting: Long-Term Results.

作者信息

Bergum Russell A, Ciota Mark R

机构信息

Orthopedics, Interventional Orthopedic Solutions, Rochester, USA.

Orthopedic Surgery, Mayo Clinic, Albert Lea, USA.

出版信息

Cureus. 2022 Jul 23;14(7):e27169. doi: 10.7759/cureus.27169. eCollection 2022 Jul.

Abstract

OBJECTIVES

To report the safety and effectiveness of office-based carpal tunnel release (CTR) using ultrasound (US) guidance in a general community population.

METHODS

This was a prospective single-center study that evaluated patients treated with CTR using US guidance between March 2019 and August 2020 for whom one-year data were available. Procedures were performed in an office-based procedure room using local anesthesia. Main outcomes of this study included complications, Boston Carpal Tunnel Questionnaire scores (BCTQ-SSS, BCTQ-FSS) and Quick Disabilities of the Shoulder and Hand (QDASH) scores.

RESULTS

Among 88 patients (123 hands) aged 30 to 89 years with available one-year data, 29 patients had simultaneous bilateral procedures. No intraoperative complications were reported. Statistically significant and clinically important improvements in BCTQ-SSS, BCTQ-FSS and QDASH scores occurred within two weeks and persisted through one year of follow-up (p < 0.001). Outcomes were similar for simultaneous bilateral releases. During follow-up, one patient developed complex regional pain syndrome that was successfully treated and subsequently had CTR using US guidance on the contralateral hand. No other complications were observed during one-year follow-up.

CONCLUSION

Office-based CTR using US guidance is safe, effective and provides sustained clinical improvements at one-year follow-up in a community population. Simultaneous bilateral procedures were well-tolerated and resulted in similar clinical improvements.

摘要

目的

报告在普通社区人群中使用超声(US)引导进行门诊腕管松解术(CTR)的安全性和有效性。

方法

这是一项前瞻性单中心研究,评估了2019年3月至2020年8月期间接受US引导下CTR治疗且有一年数据的患者。手术在门诊手术室使用局部麻醉进行。本研究的主要结果包括并发症、波士顿腕管问卷评分(BCTQ-SSS、BCTQ-FSS)和肩手快速残疾评定量表(QDASH)评分。

结果

在88例年龄30至89岁且有一年可用数据的患者(123只手)中,29例患者同时进行了双侧手术。未报告术中并发症。BCTQ-SSS、BCTQ-FSS和QDASH评分在两周内出现统计学上显著且具有临床意义的改善,并在一年的随访中持续存在(p<0.001)。双侧同时松解的结果相似。在随访期间,1例患者出现复杂性区域疼痛综合征,经成功治疗后,随后在对侧手进行了US引导下的CTR。在一年的随访中未观察到其他并发症。

结论

在社区人群中,使用US引导的门诊CTR是安全、有效的,并且在一年随访时能带来持续的临床改善。双侧同时手术耐受性良好,临床改善效果相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64c9/9308387/5427e4eb535e/cureus-0014-00000027169-i01.jpg

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