Endoscopic Release Superficial Rather Than Deep to the Transverse Carpal Ligament for Carpal Tunnel Syndrome Improves Immediate Postoperative Transient Symptomatic Exacerbation With Fewer Absences From Work

Wei, Ruihong1,2; Chen, Chao1,2; Liu, Yongqing1,2; Liu, Zhaokang1,2; Xiong, Hongtao1,2; Zhang, Xu3; Zhuang, Yongqing1,2,4,5

2023-04-01

10.1016/j.arthro.2022.09.013

ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY   影响因子和分区

0749-8063

1526-3231

Purpose: To determine the endoscopic release superficially rather than deep to the transverse carpal ligament to reduce the incidence of transient symptomatic exacerbation and postoperative absence from work in patients with carpal tunnel syndrome.Methods: From January 2012 to January 2018, patients with idiopathic carpal tunnel syndrome who un-derwent one-portal endoscopic release superficial to the transverse carpal ligament (ERSTCL) were analyzed. For com-parison, a cohort treated with the conventional Chow endoscopic release between February 2008 and October 2013 were included. Transient worsening of symptoms, discrimination sensation, and days off work were assessed. The minimal clinically important difference was calculated for discrimination sensation. Severity of symptom and functional status also were assessed using the Levine-Katz Questionnaire. Significance was set at P < .05.Results: There was a significant difference between the ERSTCL group and the control group regarding the incidence of symptomatic exacerbation 1 week after surgery (2% vs 9%; P = .003) but no difference in other time intervals within the initial 3 months. There was a significant difference in 2-point discrimination 1 week (mean change = -0.13, 95% confidence interval [CI] -0.30 to 0.04, P = .01) and 2 weeks after surgery (mean change = -0.18, 95% CI -0.36 to -0.01, P = .033). Postoperative 1 and 2 weeks, 28% and 35% patients in ERSTCL group achieved a minimal clinically important difference, respectively. Compared with control group, the difference in frequencies was statistically significant (28% vs 45%; P = .027; 35% vs 57%; P = .015). The difference between the 2 groups in postoperative absence from work was statistically significant (95% CI 1.083-4.724; P = .002), with an average reduction in sick leave of 3 days in ERSTCL group. At a mean follow-up of 3 years, no significant difference was found between the groups regarding symptom and function statuses. Conclusions: Endoscopic release superficial rather than deep to transverse carpal ligament for carpal tunnel syndrome improves immediate postoperative transient symptomatic exacerbation, which allows the patients to return to work earlier.Level of Evidence: Level III, retrospective comparative study.

SCI

英语

第一 ; 通讯

Sanming Project of Medicine in Shenzhen[SZSM201111015] ; Shenzhen Key Medical Discipline Construction Fund[SZXK024] ; Science and Technology Innovation Commission of Shenzhen[ZDSYS20200811143752005]

Orthopedics ; Sport Sciences ; Surgery

Orthopedics ; Sport Sciences ; Surgery

WOS:000992827700001

W B SAUNDERS CO-ELSEVIER INC

CLINICAL MEDICINE

Web of Science

1.Southern Univ Sci & Technol, Dept Orthoped Surg, Div Hand & Microvasc Surg, Shenzhen, Guangdong, Peoples R China
2.Southern Univ Sci & Technol, Jinan Univ,Affiliated Hosp 1, Shenzhen Peoples Hosp,Clin Med Coll 1, Shenzhen Key Lab Musculoskeletal Tissue Reconstruc, Shenzhen, Guangdong, Peoples R China
3.Hebei Med Univ, Hand Surg Dept, Hosp 3, Shijiazhuang, Hebei, Peoples R China
4.Southern Univ Sci & Technol, Dept Orthoped Surg, Div Hand & Microvasc Surg, Shenzhen 518020, Guangdong, Peoples R China
5.Southern Univ Sci & Technol, Jinan Univ,Affiliated Hosp 1, Shenzhen Peoples Hosp,Clin Med Coll 2, Shenzhen Key Lab Musculoskeletal Tissue Reconstruc, Shenzhen 518020, Guangdong, Peoples R China

Wei, Ruihong,Chen, Chao,Liu, Yongqing,et al. Endoscopic Release Superficial Rather Than Deep to the Transverse Carpal Ligament for Carpal Tunnel Syndrome Improves Immediate Postoperative Transient Symptomatic Exacerbation With Fewer Absences From Work[J]. ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY,2023,39(4).

Wei, Ruihong.,Chen, Chao.,Liu, Yongqing.,Liu, Zhaokang.,Xiong, Hongtao.,...&Zhuang, Yongqing.(2023).Endoscopic Release Superficial Rather Than Deep to the Transverse Carpal Ligament for Carpal Tunnel Syndrome Improves Immediate Postoperative Transient Symptomatic Exacerbation With Fewer Absences From Work.ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY,39(4).

Wei, Ruihong,et al."Endoscopic Release Superficial Rather Than Deep to the Transverse Carpal Ligament for Carpal Tunnel Syndrome Improves Immediate Postoperative Transient Symptomatic Exacerbation With Fewer Absences From Work".ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY 39.4(2023).