title: Carpal tunnel syndrome: electrophysiological grading and surgical results by minimum incision open carpal tunnel release.
abstract: 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.
authors.affiliation: Department of Neurosurgery, Nara Medical University, Kashihara, Nara, Japan.
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Iida
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Hirabayashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakase
authors.forename: Toshisuke
authors.initials: T
authors.lastname: Sakaki
mesh_terms: D000200:Action Potentials; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000503:physiopathology / Q000601:surgery*; D002921:Cicatrix / Q000453:epidemiology; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009431:Neural Conduction; D010149:Postoperative Pain / Q000453:epidemiology; D010292:Paresthesia / Q000209:etiology / Q000601:surgery; D012720:Severity of Illness Index; D016896:Treatment Outcome