Kulick M I, Gordillo G, Javidi T, Kilgore E S, Newmayer W L
J Hand Surg Am. 1986 Jan;11(1):59-66. doi: 10.1016/s0363-5023(86)80104-6.
This retrospective study of 100 patients who had surgical treatment for their carpal tunnel syndrome was performed to determine what factors were associated with long-term success or failure. One hundred thirty hands were treated surgically with an average follow-up of 4 years (range, 2 to 6 years). All patients were given a course of conservative treatment that included steroid injection(s) and splinting until the patients were refractory to such therapy. Over 250 injections were given (117 wrists), with the average benefit time of 27 weeks (range 0 to 330). Most patients received two to three injections (maximum of nine). Variables associated with a failure to have long-term benefit after operation included weakness or atrophy of the abductor pollicis brevis muscle, presence of a predisposing condition, and failure to benefit from the initial steroid injection. Conversely, all 51 hands that had relief from median nerve paresthesia for more than 6 months by conservative therapy alone received long-term relief after surgery. Steroids were least effective in hands that had muscle involvement. Fifteen of the 40 hands with muscle involvement regained their muscle mass by the time of the final examination.
本回顾性研究对100例接受腕管综合征手术治疗的患者进行，以确定哪些因素与长期成功或失败相关。130只手接受了手术治疗，平均随访4年（范围2至6年）。所有患者均接受了一个疗程的保守治疗，包括类固醇注射和夹板固定，直到患者对这种治疗无效。共进行了250多次注射（117例手腕），平均受益时间为27周（范围0至330周）。大多数患者接受了两到三次注射（最多九次）。与术后未能获得长期益处相关的变量包括拇短展肌无力或萎缩、存在易感因素以及未能从初始类固醇注射中获益。相反，仅通过保守治疗正中神经感觉异常缓解超过6个月的所有51只手，术后均获得了长期缓解。类固醇在有肌肉受累的手中效果最差。在最终检查时，40只有肌肉受累的手中有15只恢复了肌肉量。
