gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Artikel

Artikel empfehlen

10 years’ single center experience over different surgical techniques in treatment of carpal tunnel syndrome

Meeting Abstract

Suche in Medline nach

  • presenting/speaker Efstratios Athanaselis - Orthopaedic Dpt, University Hospital of Larissa, Larissa, Greece
  • Fotios Papageorgiou - Orthopaedic Dpt, University Hospital of Larissa, Larissa, Greece
  • Apostolos Fyllos - Orthopaedic Dpt, University Hospital of Larissa, Larissa, Greece
  • Dimitrios Deligeorgis - Orthopaedic Dpt, University Hospital of Larissa, Larissa, Greece
  • Ioannis Antoniou - Orthopaedic Dpt, University Hospital of Larissa, Larissa, Greece
  • Konstantinos Malizos - Orthopaedic Dpt, University Hospital of Larissa, Larissa, Greece
  • Sokratis Varitimidis - Orthopaedic Dpt, University Hospital of Larissa, Larissa, Greece

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1366

doi: 10.3205/19ifssh0754, urn:nbn:de:0183-19ifssh07548

Veröffentlicht: 6. Februar 2020

© 2020 Athanaselis et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objectives/Interrogation: Carpal tunnel syndrome (CTS), combined compression and traction on median nerve at wrist level, is the most common entrapment neuropathy in upper extremity and its decompression one of the most frequently performed procedures in hand surgery. We evaluated the effectiveness of different operative techniques.

Methods: Between August 2008 and March 2018, 976 operations for carpal tunnel decompression took place in our department. 643 (65.8%) were performed via a classic open approach (group A) and the rest using minimally invasive techniques such as Knife Light in 144 cases (14.7%) (group B) or two mini incisions at the proximal and distal ends of carpal tunnel in 189 cases (19.3%) (group C). Patients' records were retrospectively studied in terms of operation technique and postoperative complications.

Results and Conclusions: The majority of open procedures and all minimally invasive operations were performed by experienced hand surgeons. There was no recorded iatrogenic nerve injury, excessive hematoma formation, or deep infection. The complications included recurrence in 6 pts of group A (0.93%) and 2 pts of group B (1.4%), Complex Regional Pain Syndrome (CRPS) in 8 pts of group A (1.2%) and 2 of group C (1.0%), painful scars in 12 pts of group A (1.7%) and 2 of group B (1.4%) and pillar pain in 9 of group A (1.4%). It seems that the rate of morbidity is low, almost equally distributed in the different groups with slightly better results in groups B and C concerning volar pillar pain and scar formation.

Mini open techniques offer attractive alternative techniques in CTS operative treatment in terms of pillar pain and scar formation. However, comparable rates of complications in conjunction with required caution regarding anatomical variants and structures, learning curve and cost-effectiveness rationalize the fact that open carpal tunnel release remains the most commonly selected procedure for CTS.