Carpal Tunnel Release Experience with Minimal Wrist Incision
AbstractObjective: Carpal tunnel syndrome (CTS) is the most common peripheral trap neuropathy resulting from compression of the median nerve in the carpal tunnel of the wrist. Open release of the transverse carpal ligament is now the most commonly used method. New techniques are being developed to avoid complications of standard long curvilinear incision. Methods: Between March 2010 and January 2016, carpal tunnel release was performed by the same surgeon with 110 minimally invasive techniques in 96 patients due to CTS. Complaints and physical examination findings were compatible with CTS and mid- to severe-severity CTS cases supported by EMG were included in the study. Results: Complaints and examination findings were recorded at the post-operative 1st year outpatient clinics of the patients. Of the110 carpal tunnel release, in 50 patients (%45,5) total, in 45 patients (%40.9) significant, in 13 patients (%11,8) slight improvement were recorded, while no improvement was recorded in 2 patients (%1,8). They stated that 88% of the patients were satisfied with the operation and 12% were not satisfied. Visual Analog Scale (VAS) was used to evaluate pain complaints. The mean VAS score was 7,5 pre-operatively and 3,2 at post-operatively 1 year follow-up. Conclusion: In patients with CTS, median nerve decompression with minimal wrist incision is an effective and reliable surgical procedure.
Tarallo M, Fino P, Sorvillo V, Parisi P, Scuderi N. Comparative analysis between minimal access versus traditional accesses in carpal tunnel syndrome: a perspective randomised study. Plast Reconstr Aesthet Surg. 2014;67:237-43.
Isik HS, Bostanci U. Experience of Carpal Tunnel Syndrome that operated using a limited uni skin incision. Turk Neurosurg. 2011;21:177-80.
Yoo HM, Lee KS, Kim JS, Kim NG. Surgical Treatment of Carpal Tunnel Syndrome through a Minimal Incision on the Distal Wrist Crease: An Anatomical and Clinical Study. Arch Plast Surg. 2015;42:327-33
Graham B, Regehr G, Naglie G, Wright JG. Development and validation of diagnostic criteria for carpal tunnel syndrome. J Hand Surg Am. 2006;31:919-24.
Learmonth J.R. The principle of decompression in the treatment of certain diseases of peripheral nerves. Surg Clin North Am 1933;13:905-13
Badger SA, O'Donnell ME, Sherigar JM, Connolly P, Spence RA. Open carpal tunnel release--still a safe and effective operation. Ulster Med J. 2008;77:22-4.
Aroori S, Spence RA. Carpal tunnel syndrome. Ulster Med J. 2008;77:6-17.
Klein RD, Kotsis SV, Chung KC. Open carpal tunnel release using a 1-centimeter incision: technique and outcomes for 104 patients. Plast Reconstr Surg. 2003;15;111:1616-22.
Aydın K, Colluk C, Cengiz N, Bilgici A. Microsurgical open mini uniskin incision technique in the surgical treatment of Carpal Tunnel Syndrome. Neurology India 2006:54:64-7.
Chow JC. Endoscopic release of the carpal ligament: a new technique for carpal tunnel syndrome. Arthroscopy. 1989;5:19-24.
Açıkgöz B. Karpal Tünel Sendromu. Demircan N, Zileli M (editör). Periferik Sinir Cerrahisi. 1. Baskı Ankara: TND Spinal ve Periferik Sinir Cerrahisi Grubu Yayınları; 2008. p.281-304.
Yeo KQ, Yeo EM. Comparison of the results of open carpal tunnel release and KnifeLight carpal tunnel release. Singapore Med J. 2007;48:1131-5.
Nazzi V, Franzini A, Messina G, Broggi G. Carpal tunnel syndrome: matching minimally invasive surgical techniques. Technical note. J Neurosurg. 2008;108:1033-6.
All opinions and reports within the articles that are published in the Gazi Medical Journal are the personal opinions of author(s). Gazi University, Editors and the publisher do not accept any responsibility for these articles. The journal is printed on acid-free paper.