Local corticosteroid injection versus physical therapy for the treatment of carpal tunnel syndrome: A systematic review and meta-analysis of randomized controlled trials

Mao, Beini; Li, Yang; Yin, Yuling; Zhong, Zhang; Li, Jian; Fu, Weili

doi:10.1016/j.asjsur.2023.04.104

Cited by 1 publication

(1 citation statement)

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“…In patients with CTS, conservative treatments should be tried first and then surgical treatment methods should be applied if the patient does not benefit (Ziyal et al, 1999;Karjalanen et al, 2022;Cage et al, 2023;Mao et al, 2023). Surgically, it is aimed to decompress the median nerve by cutting the carpal ligament over the median nerve, which results in clinically significant improvement (Szabo and Steinberg, 1994;Ziyal et al, 1999).…”

Section: Discussionmentioning

confidence: 99%

Retrospective Analysis of 48 Patients Reoperated for Carpal Tunnel Syndrome

Kesılmez

Yuksel

2023

Black Sea Journal of Health Science

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Purpose: Carpal tunnel syndrome (CTS) is a condition in which the median nerve is compressed between the transverse ligament and the carpal bones. There are various techniques used in the surgical treatment of CTS. The present study aimed to investigate the reasons for reoperation by examining the reoperated cases diagnosed with CTS. Materials and Methods: Patients who underwent surgery for CTS at Kahramanmaraş Sütçü İmam University Department of Neurosurgery between January 1, 2015 and September 1, 2022 were evaluated retrospectively. Patients who underwent two or more operations with the same diagnosis were included in the study, while those operated for the first time due to CTS and with missing data were excluded. The included patients were analyzed in terms of gender, age, occupation, side of the surgery, presence of systemic diseases causing CTS such as diabetes mellitus (DM), number of the operations they underwent, time until the next operation, surgical technique, and medical branch that performed the surgery (orthopedics, neurosurgery, or plastic surgery). Findings: Forty-eight patients who met the study criteria were evaluated. Out of the 48 reoperated patients, 14 were male and 34 were female. Eighteen patients had been operated using the mini-incision open method, while 22 had undergone laparoscopic surgery, including 14 patients with biportal endoscopic surgery, and eight with uniportal endoscopic surgery. Out of the 48 patients, 31 (64.6%), 11 (22.9%), and six patients were first operated by orthopedic and traumatology physicians, plastic and reconstructive surgeons, and neurosurgeons, respectively. Conclusion: The use of open surgical technique is the gold standard in CTS and complete incision of the transverse ligament provides complete decompression of the median nerve. We believe that decompression with closed or small incisions due to aesthetic concerns may not be sufficient and may increase the risk of complications.

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