Abstract
Purpose of this study is to compare the indications and the clinical results of the surgical treatment of CTS in relation to the EMS studies.
Material & Method: From September 1998 until the end of 2002, at Lefkadas hospital, 153 patients [189 hands] were treated with surgical decompression for C.T.S. Ninety operations were executed on the right wrist, fifty-five on the left & twenty-two bilateral. 121 patients were females & 32 males.
The classic microsurgical technique was executed at 149 patients. (A three-centimeter longitudinal incision, which was never extended beyond the distal crease of wrist. At twenty-one patients, the double-incision technique was performed [a small transverse incision at the wrist’s distal crease, & a short longitudinal incision five centimeters away from the distal crease of wrist). While in 20 patients we decompressed the C.T. from just one small transverse incision at the wrist’s distal crease.
It was possible to follow up, with clinical findings and repeated EMS, only sixty of them.
All operations were executed under local anesthesia and loupes were always used.
The cases that we operated on are of medium and of advanced severity of chronic carpal tunnel syndrome, while, according to the neurologist, at least five cases were acute.
The first follow-up was done on the 2nd or 3rd postoperative day. The patients’ positive assertions that numbness – tingling and nocturnal pain that used to jolt them awake at night were cured were of a great importance.
After the sixth postoperative month, a new EMG study was performed, at the patient’s convenience. A questionnaire was given to the patient to answer.
Results: Except for four patients, two of them didn’t improve their symptoms after the operation, while the rest two after the fourth postoperative week relapsed (relapse confirmed via electromyography), all other patients had either full recovery or significant improvement. The above-mentioned results are confirmed by clinical history, physical examination, study of the answers of the questionnaire that have been given to them, and at the end of the EMG study that always have been performed (showing normal or improved status in comparison to the pre-operative state).
Conclusion: Clinical postoperative findings match electromyography studies (at least in the first postoperative year).
The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.
