Department of Rehabilitation Medicine, Incheon St. Mary`s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Rehabilitation Medicine, Howareyou Rehabilitation Clinic, Seoul, Republic of Korea.
PLoS One. 2022 Oct 21;17(10):e0276630. doi: 10.1371/journal.pone.0276630. eCollection 2022.
Previous studies have shown that, thread carpal tunnel release (TCTR), an ultrasound-guided transverse carpal ligament (TCL) transection procedure through needle and thread, to be a safe and effective technique for carpal tunnel release, compared to an open and endoscopic technique. We developed a newly improved thread (Smartwire-01, 0.27mm in diameter, Korea). This pilot study was performed to propose the effectiveness of TCTR with Smartwire-01 compared to the commercial thread in clinical settings.
A total of 22 TCTR procedures have been performed on 19 patients by one physiatrist during a 42-month period. The diagnosis of carpal tunnel syndrome was based on standard clinical criteria including electromyography (EMG). Patients were divided into two groups, one dissected with commercial thread and the other with Smartwire-01. The technique was standardized by keeping the entry point at the middle of the palm and the exit point at just medial to the palmaris longus tendon. The Numeric Rating Scale and Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) were used to assess monthly outcomes for 6 months following the procedure. The Wilcoxon signed rank test and the Mann-Whitney-U test were performed to analyze the above variables in the two groups.
There was no definite evidence that the two groups have significant differences for any of the surveyed variables. The TCTR procedure with our newly developed thread also had significant improvements for all variables, showing its effectiveness in both pain and functional ability. The NRS and BCTQ severity and functional scales showed significant decreases just after the dissection and progressive improvement during each monthly follow-up of our study until the last assessment at 6 months.
The study suggests that, our newly developed thread is as safe and effective as the commercial thread in TCTR, we therefore recommend a randomize controlled trial with above methodology.
既往研究表明，超声引导下经皮缝线腕横韧带切开术（TCTR）松解腕管与开放和内镜手术相比，是一种安全有效的方法。我们开发了一种新型缝线（Smartwire-01，直径 0.27mm，韩国）。本研究旨在提出与商业缝线相比，TCTR 中使用 Smartwire-01 的有效性。
在 42 个月期间，一名物理治疗师对 19 名患者进行了 22 例 TCTR 手术。腕管综合征的诊断基于标准临床标准，包括肌电图（EMG）。患者分为两组，一组使用商业缝线，另一组使用 Smartwire-01。通过将入口点保持在手掌中部，出口点位于掌长肌腱的内侧，使技术标准化。使用数字评分量表（NRS）和波士顿腕管综合征问卷（BCTQ）在术后 6 个月内每月评估结果。采用 Wilcoxon 符号秩检验和 Mann-Whitney-U 检验对两组上述变量进行分析。
没有明确证据表明两组在任何调查变量上存在显著差异。使用我们新开发的缝线进行 TCTR 手术也显著改善了所有变量，表明其在疼痛和功能能力方面均有效。NRS 和 BCTQ 严重程度和功能量表在手术后立即显著下降，并在我们研究的每个每月随访期间逐渐改善，直到最后 6 个月评估。
研究表明，我们新开发的缝线在 TCTR 中与商业缝线一样安全有效，因此我们建议采用上述方法进行随机对照试验。
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