| Endoscopic Carpal Tunnel Release |
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Jeong-Hwan Oh, Ja-Heon Koo |
| 내시경적 수근관 감압술 |
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오정환, 구자헌 |
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| Abstract |
Purpose
: To evaluate the clinical results & its usefulness of the endoscopic release for the carpal tunnel syndrome on the basis of day-surgery Materials and Methods : Medical records in 30 cases of consecutive endoscopic carpal tunnel releases among 19 patients from Sept. 1993 to Dec. 1998 were reviewed. All the operations were performed on the basis of day-surgery by one portal technique, but switched to two-portals if we faced with difficulties in visualization of transverse carpal ligament. No external immobilization with early active ROM exercises of the all the fingers were recommended. Mean follow-up was 36.9 months(ranged, 12-76 months), and follow-up questionnaires were given to the patient by phone or direct interviews. Results : Mean age at the time of surgery was 50.9 years (ranged, 29-60), and the fifth decade(57.9%) was the most common. There were 16 cases(53.3%) of right hand, 14 cases(46.7%) of left hand, but both in 11 cases(57.9%), and females (14 cases, 73.7%) were more commonly affected than males (5 cases, 26.3%). Mean duration of symptoms were 27.8months(ranged, 1 month to 10 years), and all the patients complained of pain or tingling sensation on their palm which were the most common and tinnel sign was the most common physical findings. According to the Cseuz's criteria for the subjective symptomatic improvement, twenty-two cases(73.3%) were graded as a good or excel-lent, but 8 cases(26.7%) were poor. Five cases among 8 poor results showed a satisfactory clinical results after open resection of the transverse carpal ligament, but two cases showed a permanent sensory changes over the third web space of the fingers. Conclusion : When comparing to the open release of the transverse carpal ligament, endoscopic carpal tunnel release is thought to be one of the useful method as it has many advantages such as a shorter skin incision, less postoperative or pillar pain, rapid functional restorations, earlier returns to work and so on, but meticulous selection of the surgical option and accurate learning of the surgical techniques should be needed for the success because of many possible complications. |
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