Mini-Open Blind Procedure Versus Limited Open Technique for Carpal Tunnel Release: A 30-Month Follow-Up Study

Cellocco, Paolo; Rossi, C.; Bizzarri, Francesco; Patrizio, Luigi; Costanzo, Giuseppe

doi:10.1016/j.jhsa.2005.02.007

Cited by 87 publications

(85 citation statements)

References 27 publications

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“…This procedure is very safe and effective, with most series reporting well over 90% success rates, but has a relatively high incidence of scar problems such as painful and hypertrophic scar formation and scar discomfort. 1,7,29,30,34) Painful and hypertrophic scar formation is thought to usually be caused by the incision crossing the wrist perpendicular to the flexion crease. Moreover, scar discomfort has been attributed to injury of the palmar cutaneous branch of the median nerve, with subsequent neuroma formation.…”

Section: Discussion I Surgical Methods and Resultsmentioning

confidence: 99%

Carpal Tunnel Syndrome: Electrophysiological Grading and Surgical Results by Minimum Incision Open Carpal Tunnel Release

Iida

Hirabayashi

Nakase

et al. 2008

Neurol. Med. Chir.(Tokyo)

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The safety and effectiveness of the minimum incision technique were assessed in 138 hands of 108 consecutive patients with carpal tunnel syndrome treated from April 1, 1997 to March 31, 2006. Clinical and electrophysiological examinations were conducted before and after surgical decompression. All hands were divided into early, mild, moderate, and severe groups based on preoperative electrophysiological severity. We examined the surgical outcomes of the affected hands in each group. Nocturnal or daytime dysesthesia, which had been present in 132 (96%) of the 138 hands preoperatively, was completely relieved in 124 (94%) of the 132 hands. Complete relief was achieved in 7 (100%) of the 7 hands in the early group, 68 (99%) of the 69 hands in the mild group, and 45 (94%) of the 48 hands in the moderate group. Complete relief was achieved only in 4 (50%) of the 8 hands in the severe group, and 3 (38%) of the 8 hands did not show any improvement. No painful or hypertrophic scar formation was observed in this series. Only 2 patients complained of postoperative scar discomfort after more than 12 months, which completely disappeared by 14 months after surgery. Minimum incision open carpal tunnel release is a safe and reliable procedure with a high rate of functional improvement and patient satisfaction. Postoperative results were satisfactory regardless of the degree of preoperative electrophysiological severity if preoperative sensory nerve action potentials were detected.

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Section: Discussion I Surgical Methods and Resultsmentioning

confidence: 99%

Carpal Tunnel Syndrome: Electrophysiological Grading and Surgical Results by Minimum Incision Open Carpal Tunnel Release

Iida

Hirabayashi

Nakase

et al. 2008

Neurol. Med. Chir.(Tokyo)

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“…The surgical options for carpal CTS treatment can be divided into three major groups: the classic open carpal tunnel release techniques, which remains as the golden standard for the surgical treatment, the endoscopic carpal tunnel release methods and the "mini-open" or limited visualization techniques, including their variations 5 . From the open techniques the main example is the approach through a variable interthenar longitudinal incision.…”

Section: Discussionmentioning

confidence: 99%

“…The advantages and disadvantages of the above techniques are a matter of debate, but their common goal is to release the median nerve by completely transecting the flexor retinaculum (FR) [5][6][7][8][9][10] . Whatever the technique, important structures such as the palmar cutaneous, recurrent motor and digital branches of the median nerve and the ulnar nerve, the superficial palmar arch and tendons must be protected during the operation 9 .…”

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confidence: 99%

Carpal tunnel syndrome: treatment with small transverse incision

Kaleff

Lima

Fernandes

et al. 2010

Arq. Neuro-Psiquiatr.

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Objective: To evaluate the application of a limited transverse incision technique to treat the carpal tunnel syndrome, with concern to its safety and efficacy in the opening of the flexor retinaculum (FR). Method: A prospective analysis of thirty FR release procedures performed on twenty-eight patients subjected to the proposed incision technique. Safety and total opening of the FR were evaluated through a questionnaire and an endoscopic inspection respectively. results: No major complications were observed. Two cases presented small local hematoma. One patient presented with transient neuropraxia of digital branch. In two of the first five cases, incomplete FR opening was identified during endoscopic revision with need of complementary opening. All patients reported relief of paresthesias and nocturnal pain symptoms. conclusion: The technique was safely performed on the prospection group, no major complications were detected and the opening of FR was observed in the majority of the patients. Key words: carpal tunnel syndrome, surgical procedures, minimally invasive, safety.Utilização de técnica de incisão transversal mínima no tratamento da síndrome do túnel do carpo resUMO Objetivo: Avaliação de técnica de incisão limitada no tratamento da síndrome do túnel do carpo, quanto à segurança clínica e efetividade na abertura do Retináculo Flexor (RF). Método: Estudo prospectivo de trinta procedimentos realizados em vinte e oito pacientes submetidos a técnica com incisão transversa mínima. A segurança da técnica e a abertura total do RF foram avaliadas através de questionário baseado em observações clinicas e inspeção endoscópica, respectivamente. resultados: Não foram observadas complicações maiores. Um único paciente apresentou neuropraxia de nervo interdigital. Dois pacientes apresentaram hematoma local pequeno. Em dois dos cinco primeiros casos observou-se uma abertura incompleta do RF, sendo necessária abertura complementar. Todos os pacientes apresentaram melhora do quadro clínico de dor noturna e parestesias. conclusão: A técnica foi executada com segurança no grupo analisado, sem a ocorrência de complicações graves, e com abertura do RF na quase totalidade dos casos. Palavras-chave: síndrome do túnel do carpo, cirurgia, minimamente invasiva, segurança.

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“…These authors found a statistically significant difference between the two treatment groups only in respect of the time of return to work, which was, on average, 8 days sooner after endoscopic operations. Cellocco et al (2005) (Richter and Bru¨ser, 1996;Saw et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Two Limited Open Techniques for Carpal Tunnel Release

Żyluk

Strychar

2006

Journal of Hand Surgery

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Review of the literature shows the effectiveness of limited open carpal tunnel release to be comparable to that of endoscopic carpal tunnel release in respect of recovery of grip strength, time of return to work and complication rate. A randomised, controlled study was designed to compare the effectiveness of a single versus a double limited open technique of carpal tunnel release. Sixty-five patients (73 hands) with a mean age of 48 years were operated on, 40 hands by the single incision and 33 by the double incision method. Grip and pinch strengths, digital sensibility (Filament and 2PD tests) and Levine scores were evaluated throughout 12 months of follow-up. We found that the single incision method offers better results in respect of grip and pinch strengths: less weakness at 1 month after surgery and a faster improvement relative to pre-operative values which is statistically significant. This, however, did not translate directly into Levine functional and symptom scores which, at each assessment, did not differ significantly between the two methods.

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Mini-Open Blind Procedure Versus Limited Open Technique for Carpal Tunnel Release: A 30-Month Follow-Up Study

Cited by 87 publications

References 27 publications

Carpal Tunnel Syndrome: Electrophysiological Grading and Surgical Results by Minimum Incision Open Carpal Tunnel Release

Carpal Tunnel Syndrome: Electrophysiological Grading and Surgical Results by Minimum Incision Open Carpal Tunnel Release

Carpal tunnel syndrome: treatment with small transverse incision

A Comparison of Two Limited Open Techniques for Carpal Tunnel Release

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