Azad Yıldırım, Ahmet Kapukaya, Şehmus Yiğit, Ramazan Atiç, Yılmaz Mertsoy, Mehmet Çaçan

Our results of mini open approach in patients with carpal tunnel syndrome

Objective: In this study, we aimed to evaluate the results of patients underwent surgical release with mini open surgical method due to Carpal tunnel syndrome (CTS) and the surgical technique.Methods: 50 wrists of the 42 patients that we could reach after they were applied mini open surgical method between 2009- 2013 were analyzed retrospectively. After surgery, patients were followed for an average 47.4 months. CTS was detected in 26 of the patients in right hand, in 10 of the patients in left hand and in seven of them bilaterally. In 27 Preoperative patients advanced in 21 intermediate and in 2 mild Electromyography (EMG) findings compliant with CTS were found.Results: We did not apply a second operation to any of our patients. None of the patients showed any post operative sensitivity on scar tissue and there was no neurovascular damage in any patients during the surgery. The patients returned to their daily activities average on the 10th day after the surgery [range 7-15 days]. In their follow up EMG was not done on a routine basis to the patients. Patients were followed clinically.Conclusion: The advantages of the surgery process we conducted with over pillar mini incision compared to other techniques that there is less pillar region pain and less scar tenderness, shorter return to work and the technique is efficient, cheap and easy to apply.Key words: Carpal tunnel, mini open, pillar

Anahtar Kelimeler:

Karpal tünel, mini açık, pillar

The comparison of Brucella gel agglutination test with other Brucella tests

Objective: In this study, it was aimed to compare the sensitivity of diagnostic tests in patients with a preliminary diagnosis of brucellosis.Methods: We have compared the serological methods, standard tube agglutination test (STA), Coombs Test (CT), Rose Bengal (RBT), and the gel centrifugation test. In patients with a preliminary diagnosis of brucellosis, subjects with a positive test result of RBT has been included in the research and other diagnostic tests STA, CT and Coombs Gel centrifugation tests were performed within the range of same titration.Results: Total 132 patient’s serums were studied. In RBT positive 92 patients’ serums, negative test results were found in 11 with STA, in 9 with CT and in 6 with gel test. While 35 patients were identified to be positive by using Brucella gel test at 1/5120 titer, no positive test results were seen with STA and CT at the same titer. Generally, CT results were one titration below the gel centrifugation test results.Conclusion: In conclusion, RBT and STA were not always adequate to determine the diagnosis of brucellosis. Low titer STA results should be supported by tests such as CT or gel centrifugation and the seroconversion must be monitored. Due to giving fast results, gel centrifugation test can be preferred in diagnosis of Brucellosis.Key words: Brucellosis, gel centrifugation, Coombs test

Keywords:

-,

PDF

___

Aydin K, Cokluk C, Piksin, et al. Ultrasonographically checking the sectioning of the transverse carpal ligament during carpal tunnel surgery with limited uni skin incisions. Turk Neurosurg 2007;17:219-223.
Kureshi SA, Friedman AH, et al. Carpal tunnel release: Surgical
considerations. Techniq Neurosurg 2000;6:5-13.
Okutsu I. Operative treatment for carpal tunnel syndrome. Brain Nerve 2007;59:1239-1245.
Singer G, Ashworth CR et al. Anatomic variations and carpal
tunnel syndrome: 10-year clinical experience. Clin Orthop Relat Res 2001;(392):330-340.
Phalen GS. The carpal tunnel syndrome: Seventeen year- experience in diagnosis and treatment of six hundred fifty four hands. J Bone Joint Surg Am 1966;48:211-228.
Zambelis T, Tsivgoulis G, Karandreas N, et al. Carpal tunnel syndrome: associations between risk factors and laterality. Eur Neurol 2010;63:43-47.
Kuhlman KA, Hennessey WJ, et al. Sensitivity and specificity
of carpal tunnel syndrome signs. Am J Phys Med Rehabil 1997;76:451-457.
Wilson KM. Double incision open technique for carpal tunnel
release: An alternative to endoscopic release. J Hand Surg 1994;19:907-912.
Thomsen NOB, Cederlund R, Rosen J, et al. Clinical outcomes of surgical release among diabetic patients with carpal tunnel syndrome: prospective follow up with matched controls. J Hand Surg 2009;34:1177-1187.
Becker J, Nora DD, Gomes I, et al. An evaluation of gender, obesity, age and diabetes mellitus as risk factors for carpal tunnel syndrome. Clin Neurophysiol 2002;113:1429-1434.
Leit ME, Weiser RW, Tomaino MM, et al. Patient reported outcome after carpal tunnel release for advanced disease: a
prospective and longitudinal assessment in patients older than age 70. J Hand Surg 2004;29:379-383.
Bickel KD. Carpal tunnel syndrome. J Hand Surg Am 2010;35:147-152.
Szabo RM. Entrapment and Compression Neuropathies. In: Green DP, Hotchkiss RN, Pederson WC (eds). Green’s Operative
Hand Surgery. Philadelphia: Churchill Livingstone Company; 1999:1404-1422.