Volume 3, 2017
|Number of page(s)||5|
|Section||Wrist & Hand|
|Published online||07 April 2017|
Can flexor tenosynovectomy and microsurgical epineurectomy improve clinical outcomes following open carpal tunnel release?
Diyarbakir Selahaddin Eyyubi State Hospital, 21100
2 Baltalimani Bone and Joint Diseases Hospital, 34470 Istanbul, Turkey
3 Faculty of Medicine, Erzincan University, 24030 Erzincan, Turkey
4 Elbistan State Hospital, 46300 Kahramanmaras, Turkey
* Corresponding author: firstname.lastname@example.org
Accepted: 24 January 2017
Introduction: The purpose of this study was to comparatively evaluate the clinical outcomes of open carpal tunnel release with or without flexor tenosynovectomy and epineurectomy for the treatment of idiopathic carpal tunnel syndrome.
Methods: In this prospective single-blinded study, 61 wrists of 47 patients randomized to open carpal tunnel release without (Group-1) or with (Group-2) flexor tenosynovectomy and microsurgical epineurectomy. Physical examination including Phalen and Tinel’s signs, visible thenar atrophy, two-point discrimination, and grip strength measurement was performed. Visual Analogue Scale (VAS), Quick Disability of Arm Shoulder Hand (DASH) Questionnaire, Symptoms Severity Scale, Functional Status Scale, and electrophysiological study were assessed.
Results: The increase in the grip strength and Quick Disability of Arm Shoulder Hand Questionnaire score were significantly better in flexor tenosynovectomy and microsurgical epineurectomy group. The average pre-operative two-point discrimination was 6.3 ± 2 mm in Group-1 and 5.8 ± 1.7 mm in Group-2. Post-operatively at the end of 12 months, the mean two-point discrimination was measured as 5.9 ± 1.6 mm in Group-1 and 5.6 ± 1.3 mm in Group-2. When we compare the two groups according to the changes in VAS, Quick-DASH, symptoms severity scale, and functional status scale, only Quick-DASH score improvement was significantly better in Group-2 (p < 0.05). Improvements in VAS, symptoms severity scale, and functional status scale did not differ significantly.
Conclusion: We do not recommend routine flexor tenosynovectomy and microsurgical epineurectomy during open carpal tunnel release in patients with idiopathic carpal tunnel syndrome.
Key words: Carpal tunnel / Median nerve / Flexor tenosynovectomy / Epineurectomy
© The Authors, published by EDP Sciences, 2017
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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