Endoscopic carpal tunnel release.

Changgeng yi xue za zhi Pub Date : 1999-09-01

H T Chen, H C Chen, F C Wei

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Abstract

Background: Endoscopic carpal tunnel release was developed by Okutsu and Chow in 1989. Many reports have indicated that endoscopic carpal tunnel release diminishes postoperative pain and accelerates the recovery time.

Methods: In a series of 1278 carpal tunnel release procedures (in 948 patients), 1214 were performed with a modified Menon endoscopic method and the remaining 64 with an open procedure. The patients with idiopathic carpal tunnel syndrome were followed for at least 3 months.

Results: Of the endoscopic release patients, 80.9% recovered grip strength equal to or greater than preoperative levels within 4 weeks, whereas in the open procedure group, the rate was only 59.3%. The difference was statistically significant (p = 0.00011). An immediate complication was one median motor nerve severance. There were 24 conversions to a conventional open procedure during endoscopic release. In the endoscopic group, 81% developed scar tenderness over the thenar crease, 31% developed new sensory disturbance, and 4% developed pillar pain.

Conclusion: Endoscopic release facilitated the recovery of grip strength and diminished the frequency of scar tenderness. However, neurovascular injury should be carefully prevented.

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内窥镜下腕管释放术。

背景:内窥镜腕管释放术由Okutsu和Chow于1989年发明。许多报告表明，内窥镜下腕管释放减少了术后疼痛，加快了恢复时间。方法:在1278例腕管松解术(948例)中，1214例采用改良的Menon内窥镜方法，其余64例采用开放手术。对特发性腕管综合征患者随访至少3个月。结果:在内镜下松解的患者中，80.9%的患者在4周内握力恢复等于或大于术前水平，而在开放手术组中，这一比例仅为59.3%。差异有统计学意义(p = 0.00011)。直接并发症是正中运动神经切断。在内窥镜释放期间，有24例转换为常规开放手术。在内窥镜组中，81%的患者在鱼际皱褶处出现疤痕压痛，31%的患者出现新的感觉障碍，4%的患者出现脊柱痛。结论:内窥镜下松解有助于恢复握力，减少瘢痕压痛发生的频率。然而，应小心防止神经血管损伤。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Changgeng yi xue za zhi

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