title: A Comparison of Hand Pain and Hand Function after Z-plasty Reconstruction of the Transverse Carpal Ligament with Traditional Median Neurolysis in Carpal Tunnel Syndrome.
abstract: BACKGROUND
  Carpal tunnel syndrome is the most common focal mono-neuropathy. A study was designed to compare the effects of traditional open carpal tunnel release with median neurolysis and Z-plasty reconstruction of the transverse carpal ligament on post-operative hand pain and hand function in patients with idiopathic carpal tunnel syndrome.
  
  
  METHODS
  Fifty-two patients with idiopathic carpal tunnel syndrome entered the study. The patients were randomly assigned into two groups to undergo simple transverse carpal ligament release or division of the ligament with Z-lengthening reconstruction. Forty-five patients completed the study. Two patients of the simple open surgery group and 5 patients of the Z-plasty reconstruction group did not complete the follow up course. After the procedure, the patients were followed to assess post-operative pain and hand function during a 12-week period.
  
  
  RESULTS
  The scores of hand pain on the first day after surgery were not statistically different between the two groups (P=0.213). But the score of hand pain was significantly lower in the Z-plasty reconstruction group at week 1, week 3, and week 6 after surgery (P<0.001). However, at week 12, no patient complained of hand pain in both groups. Considering hand function, no patient had normal hand grip after the first week, but after three weeks, a significantly higher proportion of patients in the Z-plasty reconstruction group had reached near normal hand grip (76.1% vs. 29.1%;). However, at weeks 6 and 12, the differences were not statistically different between the two groups.
  
  
  CONCLUSIONS
  We observed significant reduction in hand pain, shorter duration of hand pain and shorter period of time to reach normal hand grip by Z-plasty reconstruction of the TCL.
authors.affiliation: Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Majid Sajjadi
authors.initials: MS
authors.lastname: Saravi
authors.affiliation: Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Kariminasab
authors.affiliation: Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Bari
authors.affiliation: Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Salman
authors.initials: S
authors.lastname: Ghaffari
authors.affiliation: Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Mehran
authors.initials: M
authors.lastname: Razavipour
authors.affiliation: Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Seyed Mohamad Mehdi
authors.initials: SM
authors.lastname: Daneshpoor
authors.affiliation: Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Mahsa Vojoudi
authors.initials: MV
authors.lastname: Yazdi
authors.affiliation: Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Mehrnaz Mohammad
authors.initials: MM
authors.lastname: Davoudi
authors.affiliation: Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Masoud Shayesteh
authors.initials: MS
authors.lastname: Azar
keywords: Carpal tunnel syndrome; Hand Function; Median Neurolysis; Pillar Pain; Z-plasty