Fernandes Carlos Henrique, Meirelles Lia Miyamoto, Santos João Baptista Gomes Dos, Fernandes Marcela, Nakachima Luis Renato, Faloppa Flavio
Unidade de Cirurgia da Mão, Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil.
Rev Bras Ortop (Sao Paulo). 2022 May 16;58(2):295-302. doi: 10.1055/s-0042-1744497. eCollection 2023 Apr.
The main purpose of this research was to do an intraindividual comparison of outcomes between the open ulnar incision (OUI) and the Paine retinaculotome with palmar incision (PRWPI) techniques in patients with bilateral carpal tunnel syndrome (CTS). The patients underwent OUI surgery on one hand and PRWPI surgery on the contralateral hand. The patients were evaluated with the Boston carpal tunnel questionnaire, visual analogue scale for pain, palmar grip strength, and fingertip, key, and tripod pinch strengths. Both hands were examined in the preoperative and postoperative periods after 2 weeks, 1 month, and 3 and 6 months. Eighteen patients (36 hands) were evaluated. The symptoms severity scale (SSS) scores were higher, in the preoperative period, in the hands that underwent surgery with PRWPI ( -value = 0,023), but lower in the 3rd month postoperative ( -value = 0.030). The functional status scale (FSS) scores were lower in the periods of 2 weeks, 3 months, and 6 months ( -value = 0,016) on the hands that underwent surgery with PRWPI. In a different two-group module study, the PRWPI group presents the SSS scores average on the 2nd week and 1st month, and the FSS scores average on the 2nd week, less 0.8 and 1.2 points respectively comported to open group. The hands that underwent surgery with PRWPI presented significantly lower SSS scores at 3 months postoperative, and lower FSS scores at 2 weeks, and 3 and 6 months postoperative, compared to open surgery group.
本研究的主要目的是对双侧腕管综合征(CTS)患者采用开放尺侧切口(OUI)技术与经掌侧切口使用佩恩支持带刀(PRWPI)技术的手术效果进行个体内比较。患者一侧手接受OUI手术,对侧手接受PRWPI手术。采用波士顿腕管问卷、疼痛视觉模拟量表、手掌握力以及指尖捏力、钥匙捏力和三指捏力对患者进行评估。在术前以及术后2周、1个月、3个月和6个月对双手进行检查。共评估了18例患者(36只手)。术前,接受PRWPI手术的手的症状严重程度量表(SSS)评分更高(P值 = 0.023),但术后第3个月更低(P值 = 0.030)。接受PRWPI手术的手在术后2周、3个月和6个月时的功能状态量表(FSS)评分更低(P值 = 0.016)。在另一项两组模块研究中,PRWPI组在第2周和第1个月的SSS评分平均值以及在第2周的FSS评分平均值,分别比开放手术组低0.8分和1.2分。与开放手术组相比,接受PRWPI手术的手在术后3个月时SSS评分显著更低,在术后2周、3个月和6个月时FSS评分更低。