Nancollas M P, Peimer C A, Wheeler D R, Sherwin F S
Department of Orthopaedic Surgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, USA.
J Hand Surg Br. 1995 Aug;20(4):470-4. doi: 10.1016/s0266-7681(05)80155-x.
To determine the long-term results of carpal tunnel release, we retrospectively reviewed 60 cases, an average of 5.5 years after surgery. 87% reported a good or excellent overall outcome; the average time to maximum improvement of symptoms was 9.8 months. However, 30% reported poor to fair strength and long-term scar discomfort, and 57% noted a return of some pre-operative symptoms, most commonly pain, beginning an average of 2 years after surgery. We found no correlation between pre-operative symptoms or extent of surgical dissection (internal neurolysis) and outcome. Carpal tunnel syndrome was job related in 42%; of these, 26% changed from heavy to lighter work following surgery. Although occupational cases were slower to improve and remained off work longer, the long-term subjective results were the same for both groups. We found significant morbidity from the surgical scar and decreased strength, and often considerable delay until ultimate improvement, especially in patients with job-related carpal tunnel syndrome.
为了确定腕管松解术的长期效果，我们回顾性分析了60例患者，平均术后5.5年。87%的患者报告总体结果良好或优秀；症状达到最大改善的平均时间为9.8个月。然而，30%的患者报告力量从差到一般，且长期存在瘢痕不适，57%的患者指出术后平均2年开始出现一些术前症状复发，最常见的是疼痛。我们发现术前症状或手术解剖范围（内部神经松解）与结果之间无相关性。42%的腕管综合征与工作相关；其中，26%的患者术后从繁重工作改为较轻工作。尽管职业性病例改善较慢且停工时间更长，但两组的长期主观结果相同。我们发现手术瘢痕和力量下降会导致明显的发病率，而且往往会有相当长的延迟才会最终改善，尤其是在与工作相关的腕管综合征患者中。
