Emin BAL, Ahmet PİŞKİN, Sait ADA, Yalçın ADEMOĞLU, Tulgar TOROS, Murat KAYALAR

Açık karpal tünel gevşetmesinde iki farklı mini kesi yönteminin karşılaştırılması

Amaç: Karpal tünel sendromunun (KTS) cerrahi tedavisinde kullanılan iki farklı mini cilt kesisi yöntemi karşılaştırıldı. Çalışma planı: Çalışmada, KTS nedeniyle cerrahi tedavi uygulanan 27 hasta gevşetme için yapılan mini kesinin yerine göre iki grupta değerlendirildi. Mini kesiler grup 1’de transvers karpal bağın tam üzerinden, grup 2’de ise distalinden yapıldı. Grup 1’de 12 hasta (17 el; 1 erkek, 11 kadın; ort. yaş 55; dağılım 38-66), grup 2’de 15 hasta (17 el; hepsi kadın; ort. yaş 54; dağılım 34-71) tedavi edildi. İki grup, ağrı ve uyuşma şikayetlerindeki azalma, kesi bölgesindeki skar dokusunda sertleşme ve hassasiyet, elin kullanılmaya başlanması için geçen süre, palmar çimdikleme ve kavrama gücü ölçümleri bakımından karşılaştırıldı. Ortalama takip süresi grup 1’de 26.6 ay, grup 2’de 23.7 ay idi. Sonuçlar: Grup 1’de 14 el bileğinde (%82.4), grup 2’de ise 15 el bileğinde (%88.2) yakınmalar tamamen kayboldu. Semptomatik iyileşme açısından iki grup arasında anlamlı fark yoktu (p>0.05). Grup 1’de dokuz (%52.9), grup 2’de ise iki el bileğinde (%11.8; p

Anahtar Kelimeler:

El kuvveti, Fonksiyon iyileşmesi, Çimdikleme kuvveti, Karpal tünel sendromu, Cerrahi işlemler, minimal invaziv, Tedavi sonucu, Dekompresyon, cerrahi, Geriyedönük çalışma, Skar

Comparison between two mini incision techniques utilized in carpal tunnel release

Objectives: We compared two mini skin incision techniques utilized in the treatment of carpal tunnel syndrome (CTS). Methods: Twenty-seven patients who underwent surgery for CTS were evaluated in two groups according to the site of the mini incision performed for surgical release. A single mini skin incision was performed over the transverse carpal ligament in 12 patients (group 1; 17 hands; 1 man, 11 women; mean age 55 years; range 38 to 66 years), and on the distal side of the ligament in 15 patients (group 2; 17 hands; all women; mean age 54 years; range 34 to 71 years). The two groups were compared with regard to improvement in pain and numbness, rigidity and sensitivity of the scar tissue, time to use of the hands, and palmar pinch and grip strengths. The mean followup was 26.6 months in group 1, and 23.7 months in group 2. Results: Complete disappearance of symptoms was obtained in 14 wrists (82.4%) in group 1, and in 15 wrists (88.2%) in group 2, with no significant difference between the two groups (p>0.05). Rigidity and sensitivity of the scar tissue were seen in nine wrists (52.9%) in group 1, and in two wrists (11.8%) in group 2 (p<0.05), which lasted 3.5 months and 1.5 months, respectively. In group 2, time to use of the affected hand for basic needs (9 days) and normal function (21 days) was significantly shorter, compared to 18 days and 35 days in group 1, respectively (p<0.05). The mean differences of grip and pinch strengths of the two hands were -2.78 kg and -0.60 kg in group 1, and -0.77 and -0.46 kg in group 2, respectively (p>0.05). Conclusion: Although both methods of release yield satisfactory results in the mid- and long-term, mini skin incision performed on the distal side of the transverse carpal ligament is associated with less incision-related morbidity.

Keywords:

Hand Strength, Recovery of Function, Pinch Strength, Carpal Tunnel Syndrome, Surgical Procedures, Minimally Invasive, Treatment Outcome, Decompression, Surgical, Retrospective Studies, Cicatrix,

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