El bileğine Mini İnsizyon ile Karpal Tünel Serbestleştirilmesi Deneyimimiz

Amaç: Karpal tünel sendromu (KTS), median sinirin el bileğindeki karpal tünelde sıkışması sonucu ortaya çıkan en sık periferik tuzak nöropatidir. Transvers karpal ligamanın açık serbestleştirilmesi günümüzde en yaygın kullanılan yöntemdir. Standart uzun kurvilinear insizyonun komplikasyonlarından sakınmak için yeni teknikler geliştirilmektedir. Yöntem: Mart 2010- Ocak 2016 yılları arasında KTS nedeniyle 96 hastaya 110 minimal invazif teknik ile aynı cerrah tarafından karpal tünel serbestleştirilmesi yapıldı. Şikayet ve fizik muayene bulguları KTS ile uyumlu olup EMG ile ön tanısı desteklenmiş orta ve ağır derece KTS olguları çalışmaya alındı. Bulgular: Hastaların post-operatif 1. yıl poliklinik kontrollerindeki şikayet ve muayene bulguları kaydedildi. 110 karpal tünel serbestleştirilmesi sonrası 1. yılda, 50’sinde (%45,5) tam, 45’ inde (%40.9) belirgin, 13’ ünde (%11,8) hafif düzelme kaydedilirken 2 (%1,8) hastada düzelme olmadı. Hastaların %88’ i olduklarını ameliyattan memnun olduklarını, %12’ si memnun olmadıklarını belirtti. Hastaların ağrı değerlendirmeleri için Görsel Analog Ağrı Skalası kullanıldı. Bu değer ameliyat öncesi 7,5 iken ameliyat sonrası 1. yılda 3,2 olarak kaydedildi. Sonuç: KTS hastalarında, minimal el bileği insizyonu ile median sinirin dekompresyonu, etkin ve güvenilir bir cerrahi prosedürdür.

Carpal Tunnel Release Experience with Minimal Wrist Incision

Objective: Carpal tunnel syndrome (CTS) is the most common peripheral trapneuropathy resulting from compression of the median nerve in the carpaltunnel of the wrist. Open release of the transverse carpal ligament is now themost commonly used method. New techniques are being developed to avoidcomplications of standard long curvilinear incision.Methods: Between March 2010 and January 2016, carpal tunnel release wasperformed by the same surgeon with 110 minimally invasive techniques in 96patients due to CTS. Complaints and physical examination findings werecompatible with CTS and mid- to severe-severity CTS cases supported by EMGwere included in the study.Results: Complaints and examination findings were recorded at the post-operative 1 st year outpatient clinics of the patients. Of the110 carpal tunnelrelease, in 50 patients (%45,5) total, in 45 patients (%40.9) significant, in 13patients (%11,8) slight improvement were recorded, while no improvementwas recorded in 2 patients (%1,8). They stated that 88% of the patients weresatisfied with the operation and 12% were not satisfied. Visual Analog Scale(VAS) was used to evaluate pain complaints. The mean VAS score was 7,5 pre-operatively and 3,2 at post-operatively 1 year follow-up.Conclusion: In patients with CTS, median nerve decompression with minimalwrist incision is an effective and reliable surgical procedure.

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