بررسي مقايسه نتايج درمان سندرم تونل كارپال با روش جراحي باز و آرتروسكوپي

Comparison of treatment results of carpal tunnel syndrome by open surgical technique and Arthroscopic release

Background and aims: Carpal tunnel syndrome is a clinical condition resulting from the entrapment of the median nerve in the wrist. It is the most common compression mononeuropathy of the upper limb. In the patients with severe symptoms, surgical treatment is preferred. The purpose of this study was to compare open carpal tunnel release to single portal arthroscopic release. Methods: Sixty randomly selected patients were divided into two equal groups: the open method group and the arthroscopic method group. All the patients had clinical signs or symptoms and had not responded to the non-surgical treatment. They were followed-up for 8 months by checking the outcome and quantitative measurements of parameters in a questionnaire at discharge time and at next referral to the clinic. The parameters were compared between the two groups by using independent t-test. Results: During the visits after surgery, the patients treated with the arthroscopic method had better carpal tunnel syndrome symptom severity scores, better carpal tunnel syndrome functional status scores, and better subjective satisfaction scores (P<0.05). They also had significantly greater pinch strength, grip strength and hand dexterity (P<0.05). The open technique resulted in a greater scar length and a longer time until the patients could return to work. Good clinical outcomes and patient satisfaction were achieved more quickly when the arthroscopic method of carpal tunnel release is used. Conclusion: Single-portal arthroscopic surgery is a safe and effective method for treatment of carpal tunnel syndrome.