Artikel
A novel endoscopic technique in treating single nerve entrapment syndromes with special attention to ulnar nerve transposition and tarsal tunnel release – Development and clinical application
Eine neue retractor integrierte endoskopische Technik zur Dekompression von peripheren Nerven in Engpaßsyndromen: Klinische Anwendung
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Veröffentlicht: | 30. Mai 2008 |
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Gliederung
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Objective: To describe a simple retractor integrated endoscopic technique for treating idiopathic solitary compression neuropathies with special attention to the anterior transposition of the ulnar nerve, and to present the clinical results.
Methods: Sixty patients with ulnar sulcus syndrome, 40 with carpal tunnel syndrome, 12 with tarsal tunnel syndrome and 4 with meralgia paraesthetica were treated with the endoscopic anterior ulnar nerve transposition (49 pateints), and in situ decompression of the respective nerves (rest 67), respectively. The selection criteria were: classical nerve compression symptoms, failed conservative treatment, abnormal electrophysiology, and a non-violated anatomical region. Electrophysiological and ultrasound studies were conducted independently by physicians specializing in these techniques. Postoperative recovery was evaluated according to the 9-point Bishop rating system.
Results: Among the 49 patients with anterior ulnar nerve transposition 32 scored excellent, 15 – good and 2 – fair (mean follow-up – 20.5 months; range – 10-28 months). Among patients with in situ decompression of the ulnar nerve 5 scored excellent, 2 good and 4 fair. All patients with decompression of the carpal and tarsal tunnels, as well as meralgia parestherica, scored excellent or good results. There were two recurrences in the group with in situ decompression of the ulnar nerve. There were no technical or postoperative complications. None of the operations had to be converted to open surgery
Conclusions: We have evaluated the clinical efficacy of the novel endoscopic technique we had evolved and described before. This technique could be used to release any single nerve entrapments, or transpose nerves, or even harvest nerves for transplantation. The simplicity of the technique, and our clinical results might encourage other groups to adapt this method.