The Assessment of the Efficacy of Carboxymethyl Chitosan in the Surgical Treatment of Carpal Tunnel Syndrome: a Retrospective Study

Objective: Carpal Tunnel Syndrome (CTS) is the most commonly encountered entrapment neuropathy of the upper extremity characterized by the compression of the median nerve at the level of the wrist. The objective of the treatment is to eliminate the symptoms stemming from compression and to preserve the neurological function by relieving the median nerve of pressure. Conservative and surgical treatment methods are used effectively in Carpal Tunnel Syndrome. Anti- Adhesion barriers are used during surgery. The aim of this study is to investigate the postoperative effectiveness of carboxymethyl chitosan and methylprednisolone used intraoperatively.Methods: 87 patient files (26 males, 61 female) who were operated with the diagnosis of moderate degree Carpal Tunnel Syndrome. Peroperative local carboxymethyl chitosan gel was applied following the surgical decompression of the transverse carpal ligament in 32 patients, after surgical decompression peroperative local methylprednisolone was applied in 28 patients and only surgical decompression was performed in 27 patients. Preop and post op complaints of patients were evaluated using Symptom Severity Scale (SSS), Functional Status Score (FSS), Boston Symptom Severity Scale (BSSS), Visual Analogue Scale (VAS). Results: When pre and postoperative CNS values were evaluated according to gender and intervention groups, male patients had higher CNS values than female patients (P = 0.046). When preop and postop FSS values were evaluated according to gender and intervention groups, FSS values decreased significantly in all surgical intervention groups compared to preoperative values (P <0.001). When preop and postop VAS scores were assessed with emphasis on sex and intervention groups, VAS scores of the patients in all intervention groups showed a significant decrease as compared to preoperative scores in a time dependent manner (P<0,001).Conclusion: We compared the groups treated with CMCS and methyl prednisolone during surgical interventions for carpal tunnel syndrome with those who had undergone only surgery; we see that there was a significant decrease in the symptoms at three months.

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