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CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2021; 10(01): 065-068
DOI: 10.1055/s-0041-1725209
Original Article

Long-term Results of Two Different Surgical Techniques Used in Carpal Tunnel Syndrome

Serdar Ercan 
1   Department of Neurosurgery, Eskisehir City Hospital, Eskisehir, Turkey
,
Zeki Serdar Ataizi
2   Department of Neurosurgery, Yunus Emre State Hospital, Eskisehir, Turkey
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Abstract

Objective Carpal tunnel syndrome (CTS), the compression of the median nerve under the carpal ligament, is the most common peripheral nerve entrapment of the upper extremity. While conservative treatment is used for patients with mild and moderate symptoms, surgical treatment is preferred for severe symptoms. The aim of the study is to evaluate the difference between transverse and longitudinal incision by comparing postoperative pain and recurrence rates.

Methods The patients were divided into two groups according to the surgical incision type. Surgical intervention was applied to patients in group T (transverse incision) and group L (longitudinal incision) by the same two surgeons in each group. All patients were followed-up with electromyography (EMG) and performance scale before and after surgical treatment. If the postoperative EMG result was similar to the preoperative EMG result, it was accepted as recurrent CTS.

Results A total of 418 patients were included to the study. Six patients in the group T with transverse incision, and 18 patients in the group L with longitudinal incision, were reoperated for an average of 6 ± 2 months after the primary surgery.

Conclusion Complications are less, and recurrent nerve compression is less in longitudinal approach, since surgical intervention is performed by seeing the median nerve directly.

Keywords

peripheral nerve - carpal tunnel - entrapment - surgical approach - recurrence


Publication History

Article published online:
01 March 2021

© 2021. Neurological Surgeons’ Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 de Krom MC, de Krom CJ, Spaans F. [Carpal tunnel syndrome: diagnosis, treatment, prevention and its relevance to dentistry]. Ned Tijdschr Tandheelkd 2009; 116 (02) 97-101
    PubMedSearch in Google Scholar
  • 2 Zyluk A. Is carpal tunnel syndrome an occupational disease? A review. Pol Orthop Traumatol 2013; 78: 121-126
    PubMedSearch in Google Scholar
  • 3 Mondelli M, Giannini F, Giacchi M. Carpal tunnel syndrome incidence in a general population. Neurology 2002; 58 (02) 289-294
    CrossrefPubMedSearch in Google Scholar
  • 4 Gniadek M, Trybus M. [Carpal tunnel syndrome- etiology and treatment]. Przegl Lek 2016; 73 (07) 520-524
    PubMedSearch in Google Scholar
  • 5 Teixeira Alves MdeP. Prospective comparative study between proximal transverse incision and the conventional longitudinal incisions for carpal tunnel release. Rev Bras Ortop (English Ed.) 2015; 45 (05) 437-444
    PubMedSearch in Google Scholar
  • 6 Mardanpour K, Rahbar M, Mardanpour S. Functional outcomes of 300 carpal tunnel release: 1.5 cm longitudinal mini-incision. Asian J Neurosurg 2019; 14 (03) 693-697
    Thieme ConnectPubMedSearch in Google Scholar
  • 7 Badger SA, O’Donnell ME, Sherigar JM, Connolly P, Spence RAJ. Open carpal tunnel release–still a safe and effective operation. Ulster Med J 2008; 77 (01) 22-24
    PubMedSearch in Google Scholar
  • 8 Carlson H, Colbert A, Frydl J, Arnall E, Elliot M, Carlson N. Current options for nonsurgical management of carpal tunnel syndrome. Int J Clin Rheumatol 2010; 5 (01) 129-142
    CrossrefPubMedSearch in Google Scholar
  • 9 Yoo HM, Lee KS, Kim JS, Kim NG. Surgical treatment of carpal tunnel syndrome through a minimal incision on the distal wrist crease: An anatomical and clinical study. Arch Plast Surg 2015; 42 (03) 327-333
    Thieme ConnectPubMedSearch in Google Scholar
  • 10 Gülşen I, Ak H, Evcılı G, Balbaloglu O, Sösüncü E. A retrospective comparison of conventional versus transverse mini-incision technique for carpal tunnel release. ISRN Neurol 2013 2013; 721830
    PubMedSearch in Google Scholar
  • 11 Atroshi I, Larsson G-U, Ornstein E, Hofer M, Johnsson R, Ranstam J. Outcomes of endoscopic surgery compared with open surgery for carpal tunnel syndrome among employed patients: randomised controlled trial. BMJ 2006; 332 (7556) 1473
    CrossrefPubMedSearch in Google Scholar
  • 12 Benson LS, Bare AA, Nagle DJ, Harder VS, Williams CS, Visotsky JL. Complications of endoscopic and open carpal tunnel release. Arthroscopy 2006; 22 (09) 919-924 924.e1–924.e2
    CrossrefPubMedSearch in Google Scholar
  • 13 Jiménez Del Barrio S, Bueno Gracia E, Hidalgo García C. et al. Conservative treatment in patients with mild to moderate carpal tunnel syndrome: a systematic review. Neurologia (English Ed.) 2018; 33 (09) 590-601
    CrossrefPubMedSearch in Google Scholar
  • 14 Aslani HR, Alizadeh K, Eajazi A. et al. Comparison of carpal tunnel release with three different techniques. Clin Neurol Neurosurg 2012; 114 (07) 965-968
    CrossrefPubMedSearch in Google Scholar