Rellan Ignacio, Donndorff Agustín Guillermo, Gallucci Gerardo Luis, De Carli Pablo, Bronenberg Victorica Pedro, Avanzi Rocio, Huespe Ivan Alfredo, Boretto Jorge Guillermo
Department of Orthopaedics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Instituto de Ortopedia y Traumatología "Carlos E. Ottolenghi,", Potosí 4215 (C1199ACK), Buenos Aires, Argentina.
J Hand Microsurg. 2024 Sep 27;17(2):100165. doi: 10.1016/j.jham.2024.100165. eCollection 2025 Mar.
To prospectively address our patients seeking carpal tunnel release (CTR) to evaluate the incidence, intensity, and duration of pillar pain (PP) and its correlation with catastrophic thinking, depression, and health anxiety.Methods: this is a prospective cohort study consisting of patients who underwent mini-open CTR under WALANT. Pillar pain was evaluated using the table test and was recorded as dichotomous variable and rated with a visual analogue scale (VAS). Patients with a positive result were evaluated on a monthly basis until the test yielded a negative result.To assess catastrophic thinking, health anxiety and depression levels, we employed the Pain Catastrophizing Scale (PCS) the Short Health Anxiety Inventory (SHAI), and the Beck scale respectively.
The study enrolled 170 patients who underwent CTR using WALANT technique. Among them, 84 patients (49 %) exhibited a positive table test. With exception of age and diabetes, both groups showed comparable demographic characteristics.The mean pain score for patients with a positive test was 3.5 ± 1.5, and the median duration of it was 3 months (interquartile range [IQR] 2-4). The median PCS score was 8 (IQR 2-14) in patients without PP, compared to 8 (IQR 4-11) in patients with PP. In the logistic regression model, the PCS variable had a crude odds ratio (OR) of 1 (95 % CI: 0.96-1.03) and an adjusted OR of 1 (95 % CI: 0.97-1.04). The SHAI score showed a crude OR of 0.97 (95 % CI: 0.93-1.01) and an adjusted OR of 0.97 (95 % CI: 0.92-1.01). The BECK score had a crude OR of 0.99 (95 % CI: 0.96-1.03) and an adjusted OR of 1.02 (95 % CI: 0.98-1.06).
Patients undergoing mini-open CTR have a risk of 49 % of experiencing PP, which typically registers a pain intensity of approximately 3 points and will last for a median of 3 months. The likelihood of experience it does not depend on catastrophic thinking, depression, and health anxiety.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.
前瞻性地研究寻求腕管松解术（CTR）的患者，以评估柱部疼痛（PP）的发生率、强度和持续时间及其与灾难性思维、抑郁和健康焦虑的相关性。
这是一项前瞻性队列研究，纳入在腕部局部麻醉无止血带技术（WALANT）下接受小切口腕管松解术的患者。使用表格测试评估柱部疼痛，并记录为二分变量，并用视觉模拟量表（VAS）评分。阳性结果的患者每月进行评估，直至测试结果为阴性。为了评估灾难性思维、健康焦虑和抑郁水平，我们分别采用了疼痛灾难化量表（PCS）、简短健康焦虑量表（SHAI）和贝克量表。
该研究纳入了170例接受WALANT技术腕管松解术的患者。其中，84例患者（49%）表格测试呈阳性。除年龄和糖尿病外，两组的人口统计学特征具有可比性。测试阳性患者的平均疼痛评分为3.5±1.5，中位持续时间为3个月（四分位间距[IQR]2 - 4）。无PP患者的PCS中位评分为8（IQR 2 - 14），有PP患者为8（IQR 4 - 11）。在逻辑回归模型中，PCS变量的粗比值比（OR）为1（95%CI：0.96 - 1.03），调整后OR为1（95%CI：0.97 - 1.04）。SHAI评分的粗OR为0.97（95%CI：0.93 - 1.01），调整后OR为0.97（95%CI：0.92 - 1.01）。BECK评分的粗OR为0.99（95%CI：0.96 - 1.03），调整后OR为1.02（95%CI：0.98 - 1.06）。
接受小切口腕管松解术的患者有49%的风险发生PP，其疼痛强度通常约为3分，中位持续时间为3个月。发生PP的可能性不取决于灾难性思维、抑郁和健康焦虑。
研究类型/证据水平：预后性II级。
