Intra-individual evaluation of results between open and endoscopic release in bilateral carpal tunnel syndrome

Abstract

ObjectiveThe authors performed an intra-individual comparison of surgical results between the open and endoscopic surgical techniques in patients with bilateral carpal tunnel syndrome. Each hand was submitted to surgery using one of these techniques.MethodsFifteen patients (30 hands) were evaluated by the Boston Questionnaire, visual analogue pain scale, palmar grip strength, and for tip, key, and tripod pinch strengths. These measurements were taken before surgery and at two weeks, one month, three months, and six months after the procedure. Scores for each evaluation tool in each evaluation time period were compared.ResultsIn comparison to the group submitted to open surgery, the group submitted to endoscopic surgery had worse scores in the evaluation of the 1st and 6th postoperative months regarding the severity of the symptoms. The authors found no differences in the functional status of the hand. Regarding the intensity of pain evaluated by the visual analogue pain scale, no difference was found between the averages in all time periods evaluated. No differences in palmar grip strength and in fingertip, key (lateral), and tripod pinch strengths were found in all time periods. There were no differences between averages in the preoperative period at two weeks, one month, and three months after surgery. After six months, the group of patients submitted to open surgery presented greater tripod force than the group of patients who underwent endoscopic surgery.ConclusionNo differences were observed by using the intra-individual evaluation in the results between open and endoscopic techniques for the treatment of carpal tunnel syndrome.

Epidemiology and approach in Carpal Tunnel Syndrom: An analysis of the impact on return on labor

“…Domestic workers make up 54.2% of patients with bilateral CTS. Data from the national literature show that Carpal Tunnel Syndrome finds a higher prevalence among people who perform activities that require grip strength and repetitive movement in flexion and / or wrist extension, 7,14 which corroborates the data of the presented occupational profile and our research.…”

“…It also coincides with the primacy of the change in the dominant dimension, which, in the majority of the population, is the right. 14,15,22,24 The data found that the mean course of the disease, between the onset of symptoms and the recommended treatment, lasted between 6 and 10 years, in which time chronicity of CTS is considered until its resolution. This information raised by our research corroborates the literature, which predicted an average of 4.3 years of chronification of the syndrome.…”

“…The technique employed depends on the preference and skill of the surgeon, available materials and patient characteristics. 6,14 Occupational therapy rehabilitation should be started early after surgery and have the purpose of promoting independence in activities of daily living and return to work. 15,16 The objective of this study was to characterize the profile of patients with a diagnosis of Carpal Tunnel Syndrome submitted to median nerve neurolysis treated at a tertiary level hospital of the SUS, identifying the epidemiological, clinical and occupational profile of these patients and analyzing the labor situation of the patients after medical and therapeutic treatments.…”