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改良超微创超声引导下腕管松解术后的早期术后恢复

Early Postoperative Recovery after Modified Ultra-Minimally Invasive Sonography-Guided Thread Carpal Tunnel Release.

作者信息

Mende Konrad, Kamphuis Saskia J M, Schmid Valentin, Schaefer Dirk J, Kaempfen Alexandre, Gohritz Andreas

机构信息

Clinic of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland.

出版信息

J Pers Med. 2023 Mar 31;13(4):610. doi: 10.3390/jpm13040610.

Abstract

Thread carpal tunnel release (TCTR) has been reported to be safe and effective for the treatment of carpal tunnel syndrome. The aim of this study is to evaluate the modified TCTR for safety, efficacy, and postoperative recovery. Seventy-six extremities in 67 patients undergoing TCTR were analyzed pre- and postoperatively using clinical parameters and patient-reported outcome measures. Twenty-nine men and 38 women with a mean age of 59.9 ± 18.9 years underwent TCTR. The mean postoperative time to resume activities of daily living was 5.5 ± 5.5 days, analgesia was completed after 3.7 ± 4.6 days, and return to work was achieved after a mean of 32.6 ± 15.6 days for blue-collar workers and 4.6 ± 4.3 days for white-collar workers. The Boston Carpal Tunnel Questionnaire (BCTQ) and Disability of Arm, Shoulder, and Hand (DASH) scores were comparable with previous studies. Overall, two persistent compressions and one recurrence required open reoperation (3.9%). All three had been operated in the initial phase, and none required reoperation after an additional safety step was introduced. No other complications occurred. TCTR surgery appears to be a safe and reliable technique with almost no wound and scarring and a potentially faster recovery time than open techniques. Although our technical modifications may reduce the risk of incomplete release, TCTR requires both ultrasound and surgical skills and has a considerable learning curve.

摘要

据报道,经皮腕管松解术(TCTR)治疗腕管综合征安全有效。本研究旨在评估改良TCTR的安全性、有效性及术后恢复情况。对67例行TCTR手术患者的76个肢体进行术前和术后分析,采用临床参数及患者报告的结局指标。29例男性和38例女性接受了TCTR手术,平均年龄为59.9±18.9岁。术后恢复日常生活活动的平均时间为5.5±5.5天,镇痛在3.7±4.6天后完成,蓝领工人平均32.6±15.6天后恢复工作,白领工人平均4.6±4.3天后恢复工作。波士顿腕管问卷(BCTQ)和上肢、肩部和手部功能障碍(DASH)评分与先前研究相当。总体而言,2例持续性压迫和1例复发需要行开放性再次手术(3.9%)。这3例均在初始阶段接受手术,在引入额外安全步骤后均无需再次手术。未发生其他并发症。TCTR手术似乎是一种安全可靠的技术,几乎无伤口和瘢痕,恢复时间可能比开放技术更快。尽管我们的技术改良可能会降低不完全松解的风险,但TCTR需要超声和手术技能,且有相当长的学习曲线。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2963/10145732/80d94ee4ad49/jpm-13-00610-g001.jpg

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