Roth J H, Richards R S, MacLeod M D
Department of Surgery, University of Western Ontario, London.
Can J Surg. 1994 Jun;37(3):189-93.
To assess the efficacy and safety of a new technique for carpal tunnel release.
A single-group prospective cohort study.
A referral-based hand-surgery university practice.
Ninety-five consecutive adults; 1 patient was excluded (35 men, 59 women). They underwent 108 surgical procedures. No patients were lost to follow-up.
Endoscopic carpal tunnel release. Outpatient surgery with neuroleptic anesthesia. Two-portal Chow technique of release.
Symptom relief, return to work, medication use and complication rate.
The average preoperative duration of symptoms was 3.9 years. Nerve conduction studies were positive in 101 of the 108 hands. Only two patients required open release. Only eight patients complained of intraoperative pain. Six patients failed to obtain relief of symptoms; two of them required secondary open release owing to persistent symptoms. Of the 61 patients who were employed, 52 returned to their previous jobs without restriction. The mean time for return to work was 36.4 days for patients who were Workers' Compensation Board cases and 19.5 days for patients who were not (p < 0.01). Men returned to work in 17.7 days and women in 24.7 days (p < 0.05). Complications occurred in four patients (3.8%). No nerve injury, vascular injury or reflex sympathetic dystrophy was noted. Patients who had undergone previous contralateral open release noted less pain and earlier return to work after endoscopic carpal tunnel release.
Endoscopic carpal tunnel release was effective in relieving symptoms and had a low complication rate. The technique was associated with early return to work and minimal palmar pain.
评估一种腕管松解新技术的疗效和安全性。
单组前瞻性队列研究。
一所基于转诊的大学手外科诊所。
95例连续成年患者；排除1例患者（35例男性，59例女性）。他们接受了108例外科手术。无患者失访。
内镜下腕管松解术。采用精神安定麻醉的门诊手术。双切口Chow松解技术。
症状缓解情况、恢复工作情况、药物使用情况及并发症发生率。
术前症状平均持续时间为3.9年。108只手中有101只的神经传导研究呈阳性。仅2例患者需要切开松解。仅8例患者主诉术中疼痛。6例患者症状未缓解；其中2例因症状持续需要二次切开松解。在61例有工作的患者中，52例无限制地回到了原来的工作岗位。工伤赔偿委员会病例的患者平均恢复工作时间为36.4天，非工伤赔偿委员会病例的患者为19.5天（p<0.01）。男性恢复工作的时间为17.7天，女性为24.7天（p<0.05）。4例患者（3.8%）出现并发症。未发现神经损伤、血管损伤或反射性交感神经营养不良。既往接受过对侧切开松解的患者在内镜下腕管松解术后疼痛较轻且恢复工作较早。
内镜下腕管松解术在缓解症状方面有效，并发症发生率低。该技术与早期恢复工作及最小化手掌疼痛相关。
