This study presents over three hundred cases of surgical decompression of the median nerve in patients with carpal tunnel syndrome (STC), performed trough the period November 1991-April 1998. Aspects such as the following were considered: age, gender, side, occupation, associated pathologies; those concerning the nerve at both the preoperatory and intraoperatory stage, the epineurium, tendon synovial fluid and the palmar carpal ligament. Neurophysiological and clinical follow-up ensued, considering return to occupational activity, improvement and normalization of nervous conduction, complications and recurrenccs. The open technique was used, but with minimum invasiveness and by proximo-distad subcutaneous intervention, permitting extensive decompression and exploration not only of the nerve but also of the tendon structures passing trough the carpal canal. Rather than being immobilized, during admission patients underwent early assisted active kinesitherapy. All were subjected to electrophysiological testing prior to surgery and a group of 99 patients (= 120 median nerves) was included in an electrophysiological follow-up protocol comprising 7 tests, up to 24 months after surgery. On clinical-anamnestic follow-up after a mean period of approximately three years, only one recurrence emerged, confirmed by neurographic testing, plus a few cases of transitory painful symptomatology in proximity to the skin scar, which were spontaneously resolved. Hence, in the opinion of the authors, this technique provides a good compromise between invasiveness and treatment considering, on the one hand, conventional open, broadly incisional techniques and, on the other, more sophisticated but elaborate and more limited endoscopic techniques.
|Translated title of the contribution||Carpal tunnel syndrome: A case study|
|Number of pages||7|
|Journal||Rivista Italiana di Chirurgia Plastica|
|Publication status||Published - 1998|
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