[2 1/2 years experience with endoscopic carpal tunnel release].
We have been performing endoscopic carpaltunnel release using the two-portal technique since November 1992. Altogether, 139 hands were operated on until November 1993, among them 35 endoscopically. All patients were examined pre- and postoperatively. Beyond the known advantages (less postoperative pain, earlier return to work and less loss of grip strength), the complications (one case of hematoma and three cases of hypaesthesia in the trip of the middle finger) and one reoperation (incomplete release) were analyzed. Interestingly, two of the five patients who were operated on both hands (endoscopic and open method) preferred the open method. These patients complained of persistent morning stiffness after endoscopic release. After modification of the method (i.e. mobilization of the soft tissue from the retinaculum in the distal incision before insertion of the slotted cannula), we resumed our trials which lasted until the end of 1994. The patients were selected preoperatively. In our opinion, the endoscopic method should not be performed on patients with hypertrophic synovium, metabolic or rheumatic diseases, extreme posttraumatic or arthritic deformities, thenar atrophy, scars, as well as patients with distal ulnar nerve compression. During the second trial, 41 hands of 126 were endoscopically operated. In this follow-up group, the results were better than in the first group due to careful selection of patients (no complications and no reoperations).
Mascharka
Z
Z
Klinik für Unfallchirurgie und Orthopädie, Städtisches Klinikum Fulda.
D001182:Arthroscopy; D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D000075202:Contraindications; D004724:Endoscopy; D005500:Follow-Up Studies; D006801:Humans; D017060:Patient Satisfaction; D018579:Patient Selection; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D016896:Treatment Outcome; D014938:Work Capacity Evaluation
Zweieinhalbjährige Erfahrung mit der endoskopischen Karpaltunnelspaltung.