Carpal Tunnel Syndrome: Open or Endoscopic Release Surgery Method? | ||
The Archives of Bone and Joint Surgery | ||
مقاله 5، دوره 10، شماره 8، آبان 2022، صفحه 677-682 اصل مقاله (430.59 K) | ||
نوع مقاله: RESEARCH PAPER | ||
شناسه دیجیتال (DOI): 10.22038/abjs.2022.58577.2899 | ||
نویسندگان | ||
Babak Hajibarati1؛ Hojjat Molaei2؛ Alireza Hasanzadeh3؛ Ali Ahmadzade4؛ Maryam Mirshahi5؛ Hosseinali Abdorrazzaghi* 6 | ||
1Division of Plastic and Reconstructive Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran | ||
2Division of Plastic and Reconstructive Surgery, Department of Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran | ||
3Medical School, Tehran University of Medical Sciences, Tehran, Iran | ||
4Medical School, Tehran University of Medical Sciences, Tehran, Iran | ||
5Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran | ||
6Division of Reconstructive Surgery, Department of Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran | ||
چکیده | ||
Background: Carpal tunnel syndrome (CTS) or median nerve neuropathy is among the causes of numbness, paresthesia, and sensory and motor dysfunction in the affected hand. The objective of this study was to compare open and endoscopic carpal tunnel release (ECTR) methods. Methods: A multicenter, historical cohort study was performed on 47 hands in 46 patients with a clinical diagnosis of CTS and a failed trial of conservative treatment. Samples were divided into two groups consisting of 23 patients receiving open carpal tunnel release (OCTR) and ECTR. Outcome measurements had been carried out six weeks after the operation and included handgrip strength, post-op pain, and missing job days. Results: Patients in both groups were comparable regarding baseline characteristics such as age, gender, and handgrip strength. Both methods significantly improved handgrip strength. No significant difference was detected between the two groups concerning handgrip strength improvement (P=0.700) and sick leave days (P=0.564). Open carpal tunnel release resulted in more significant post-op pain (mean 5.91±1.24 compared to 2.43±0.73 after endoscopic release), which was significant (P=0.000). No complications were reported with any technique. Conclusion: This study revealed that apart from post-op pain, other investigated endpoints were similar in both groups. Although the small sample size has limited our ability to draw a conclusive statement, these data suggest that there is no need to utilize the endoscopic technique for the optimum result, especially when this method requires more advanced equipment and could increase surgery costs. Therefore, both approaches can result in good clinical outcomes. Level of evidence: III | ||
کلیدواژهها | ||
Carpal tunnel syndrome؛ Endoscopy؛ Endoscopic carpal tunnel release؛ Hand strength؛ Open carpal tunnel release | ||
مراجع | ||
1. Devana SK, Jensen AR, Yamaguchi KT, D’Oro A, Buser Z, Wang JC, et al. Trends and Complications in Open Versus Endoscopic Carpal Tunnel Release in Private Payer and Medicare Patient Populations. Hand (N Y). 2019;14(4):455-61. 2. Middleton SD, Anakwe RE. Carpal tunnel syndrome. BMJ. 2014;349:g6437. 3. Dale AM, Harris-Adamson C, Rempel D, Gerr F, Hegmann K, Silverstein B, et al. Prevalence and incidence of carpal tunnel syndrome in US working populations: pooled analysis of six prospective studies. Scand J Work Environ Health. 2013;39(5):495-505. 4. Atroshi I, Zhou C, Jöud A, Petersson IF, Englund M. Sickness absence from work among persons with new physician-diagnosed carpal tunnel syndrome: a population-based matched-cohort study. PLoS One. 2015;10(3):e0119795-e. 5. Foley M, Silverstein B, Polissar N. The economic burden of carpal tunnel syndrome: long-term earnings of CTS claimants in Washington State. Am J Ind Med. 2007;50(3):155-72. 6. Abdorrazzaghi H, Hajibarati B, Mohammadi F. Reverse Sural Fascio-Cutaneous Flap for Management of Patients with Distal Third of Lower Limb Soft Tissue Defects Referring to the Emergency Department Following Traumatic Events; A Review of 13 Cases. Frontiers in Emergency Medicine. 2021;5(3):e33. 7. Gerritsen AA, de Vet HC, Scholten RJ, Bertelsmann FW, de Krom MC, Bouter LM. Splinting vs surgery in the treatment of carpal tunnel syndrome: a randomized controlled trial. JAMA. 2002;288(10):1245-51. 8. Chesterton LS, Blagojevic-Bucknall M, Burton C, Dziedzic KS, Davenport G, Jowett SM, et al. The clinical and cost-effectiveness of corticosteroid injection versus night splints for carpal tunnel syndrome (INSTINCTS trial): an open-label, parallel group, randomised controlled trial. Lancet. 2018;392(10156):1423-33. 9. Klokkari D, Mamais I. Effectiveness of surgical versus conservative treatment for carpal tunnel syndrome: A systematic review, meta-analysis and qualitative analysis. Hong Kong Physiother J. 2018;38(2):91-114. 10.Okutsu I, Ninomiya S, Takatori Y, Ugawa Y. Endoscopic management of carpal tunnel syndrome. Arthroscopy. 1989;5(1):11-8. 11.Martinez-Catasus A, Lobo-Escolar L, Garcia-Bonet J, Corrales-Rodriguez M, Pasarin-Martinez A, Berlangade-Mingo D. Comparison between single portal endoscopic and 1-cm open carpal tunnel release. Hand Surg Rehabil. 2019;38(3):202-6. 12.Gerritsen AA, Uitdehaag BM, van Geldere D, Scholten RJ, de Vet HC, Bouter LM. Systematic review of randomized clinical trials of surgical treatment for carpal tunnel syndrome. Br J Surg. 2001;88(10):1285-95. 13.Chen L, Duan X, Huang X, Lv J, Peng K, Xiang Z. Effectiveness and safety of endoscopic versus open carpal tunnel decompression. Arch Orthop Trauma Surg. 2014;134(4):585-93. 14.Kumnerddee W, Kaewtong A. Efficacy of acupuncture versus night splinting for carpal tunnel syndrome: a randomized clinical trial. J Med Assoc Thai. 2010;93(12):1463-9. 15.D’Arcy CA, McGee S. The rational clinical examination. Does this patient have carpal tunnel syndrome? Jama. 2000;283(23):3110-7. 16.Karamanos E, Jillian BQ, Person D. Endoscopic Carpal Tunnel Release: Indications, Technique, and Outcomes. Orthop Clin North Am. 2020;51(3):361-8. 17.Vianna LC, Oliveira RB, Araújo CGS. Age-related decline in handgrip strength differs according to gender. The Journal of Strength & Conditioning Research. 2007;21(4):1310-4. 18.Vasiliadis HS, Georgoulas P, Shrier I, Salanti G, Scholten RJ. Endoscopic release for carpal tunnel syndrome. Cochrane Database Syst Rev. 2014(1):Cd008265. 19.Zuo D, Zhou Z, Wang H, Liao Y, Zheng L, Hua Y, et al. Endoscopic versus open carpal tunnel release for idiopathic carpal tunnel syndrome: a meta-analysis of randomized controlled trials. J Orthop Surg Res. 2015;10:12. 20.Li Y, Luo W, Wu G, Cui S, Zhang Z, Gu X. Open versus endoscopic carpal tunnel release: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord. 2020; 21(1):1-6 | ||
آمار تعداد مشاهده مقاله: 702 تعداد دریافت فایل اصل مقاله: 498 |