title: Treatment for carpal tunnel syndrome by coronal Z-type lengthening of the transverse carpal ligament.
abstract: OBJECTIVE
  To compare the effects of coronal Z-type lengthening of transverse carpal ligament with conventional open approach for carpal tunnel syndrome.
  
  
  METHODS
  A double-blinded study was conducted from January 2005 to August 2008 on 68 patients with a mean age of 41 years (range 27-55 years) diagnosed as severe carpal tunnel syndrome. They were randomized into two groups(A and B). Patients in group A underwent coronal Z-type lengthening of transverse carpal ligament; and patients in group B had conventional open approach surgery. Postoperative evaluation was scheduled at 1, 3, 6 and 12 months after the surgery and incidence rate of bowstring of the flexor tendons, improvement of grip strength and ADL activities of daily living) score were recorded.
  
  
  RESULTS
  Fifty-eight patients had been followed up successfully, 30 and 28 for group A and B respectively. The Scar Tissue Formation of the flexor tendons in group B was observed more than that in group A at 6 and 12 month after operation. Improvement of grip strength were observed in two groups, which was statistically different between 6 and 12 months after operation and no significant difference was seen between 1 and 3 months after operation. According to ADL, the satisfaction rates documented on form for patients were statistically different in the two groups at 6 and 12 months after operation and no difference was noted at 1 and 3 months after operation.
  
  
  CONCLUSIONS
  Excellent improvement of function and satisfaction were achieved by Coronal Z-type reconstruction of the flexor retinaculum for severe carpal tunnel syndrome. Our method offers a more effective alternative method for conventional carpal tunnel open decompression surgery.
authors: Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors: Lin
authors: L
authors: Xu
authors: Fei
authors: F
authors: Huang
authors: Chunlin
authors: C
authors: Hou
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000601:surgery*; D002921:Cicatrix / Q000473:pathology; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008022:Ligaments / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D020127:Recovery of Function; D017678:Sex Distribution; D013997:Time Factors; D016896:Treatment Outcome; D014955:Wrist Joint / Q000503:physiopathology / Q000601:surgery