[Neurolysis of the median nerve at the wrist with 2-portal endoscopic technique. Analysis of 102 consecutive cases].
Based on a retrospective clinical series, the authors evaluated the results of endoscopic nerve release according to Chow's technique, particularly in terms of the complications. The population consisted of 96 patients, corresponding to 102 hands, operated between January 1993 and January 1996. Paraesthesiae had completely resolved at 3 months in 87.2% of cases, while 29.7% of patients complained of discomfort in the hypothenar region. At last review, with a mean follow-up of 13.5 months, paraesthesiae had completely resolved in the same proportion of patients. 93.3% of patients with discomfort in the hypothenar region reported complete cure and 94 patients (92.2%) declared to be satisfied. Eighteen patients were operated on both sides. None of them preferred the conventional technique either in the short-term or in the long-term. One case of section of the superficial palmar arch, one case of severe reflex sympathetic dystrophy, one neurological complication (1%) in the form of dysaesthesia in the middle finger, persisting at last follow-up, one incomplete opening of the extensor retinaculum subsequently repaired via an open approach. Chow's technique presents certain advantages in terms of postoperative comfort, but the safety of this technique must be ensured by prevention of neurovascular complications, based on respect of 3 golden rules: thorough training in the technique, preferably in the anatomy laboratory, open conversion at the slightest doubt concerning visibility of the extensor retinaculum and compliance with the absolute contraindications of the technique.
Le Nen
D
D
Service de Chirurgie Orthopédique, Traumatologique et Réparatrice, Hôpital de la Cavale Blanche, CHU, Brest.
Rizzo
C
C
Hu
W
W
Brunet
P
P
D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010292:Paresthesia / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies
Neurolyse du nerf médian au poignet selon la technique endoscopique à deux voies. Analyse de 102 cas consécutifs.