Bilateral endoscopic carpal tunnel releases: Simultaneous versus staged operative intervention
Bilateral endoscopic carpal tunnel releases: Simultaneous versus staged operative intervention
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DOI：
10.1053/jars.2002.30643
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发表时间：
2002-03-01
影响因子：
4.7
通讯作者：
McCarthy, JA
中科院分区：
文献类型：
--
作者：
Fehringer, EV;Tiedeman, JJ;McCarthy, JA
目的：开放和内镜下腕管释放技术治疗腕管综合征取得了良好的效果。症状经常发生在双侧，但没有同时手术干预的报道。本研究的目的是评估分阶段进行双侧内窥镜腕管松解术的患者和同时进行双侧松解术的患者的结果。研究类型：回顾性研究。方法：采用回顾性图表法评价同时和分期双侧内窥镜腕管松解术的疗效。这包括在48个月期间接受这些手术的患者。A组（48例）分期手术；B组同期手术48例。纳入标准为阳性病史和体格检查、阳性电学研究和保守措施失败。单切口内窥镜释放术在门诊基础上进行。采用间歇性夹板进行早期康复，分析包括并发症、满意度、重返工作、医生就诊、物理治疗时间、所有患者达到最大医疗改善的天数，以及工伤赔偿患者永久性部分损伤的平均百分比。结果：与未提出工伤赔偿要求的分阶段组相比，同时组的正常工作返回率下降（P = 0.0158）。同时组就诊次数少于分阶段组（P = 0.0002）。患者总体满意度相等。结论：同时双侧内窥镜下腕管释放术具有良好的耐受性，限制轻微，成本降低。
Purpose: Open and endoscopic carpal tunnel release techniques have achieved excellent results for treatment of carpal tunnel syndrome. Symptoms frequently occur bilaterally but there are no reports of simultaneous operative intervention. The purpose of this study was to evaluate results in patients who underwent staged bilateral endoscopic carpal tunnel releases and in those who underwent simultaneous bilateral releases. Type of Study: Retrospective review. Methods: The efficacy of simultaneous and staged bilateral endoscopic carpal tunnel releases was evaluated using a retrospective chart review. This included patients who underwent these procedures during a 48-month period. Group A (48 patients) underwent staged procedures; group group B (48 patients) underwent simultaneous procedures. Inclusion criteria were a positive history and physical examination, positive electrical studies, and failure of conservative measures. Single-incision endoscopic releases were performed on an outpatient basis. Early rehabilitation with intermittent splinting was utilized, The analysis included complications, satisfaction, return to work, physician visits, physical therapy sessions, days to maximum medical improvement for all, and average percentage permanent partial impairment for Workers' Compensation patients. Results: A decrease in return to work at regular duty was noted in the simultaneous group compared with the staged group for patients who had not filed Workers' Compensation claims (P = .0158). The simultaneous group had fewer physician visits than the staged group (P = .0002). Overall patient satisfaction was equal. Conclusions: Simultaneous bilateral endoscopic carpal tunnel releases are well tolerated with mild restrictions and a decrease in cost.