Evaluation of patients with carpal tunnel syndrome treated
               by endoscopic technique

Okamura, Aldo; Meirelles, Lia Miyamoto; Fernandes, Carlos Henrique; Raduan Neto, Jorge; Santos, João Baptista Gomes dos; Faloppa, Flávio

doi:10.1590/S1413-78522014000100005

Acessibilidade / Reportar erro

Brasil

Acta Ortopédica Brasileira

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Articles • Acta ortop. bras. 22 (01) • 2014 • https://doi.org/10.1590/S1413-78522014000100005 copy

Evaluation of patients with carpal tunnel syndrome treated by endoscopic technique

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

To evaluate the postoperative results of patients with carpal tunnel syndrome by the endoscopic release technique with single portal.

Methods:

78 patients (80 wrists) were evaluated preoperatively and postoperatively at 1, 3 and 6 months by the Boston questionnaire, the visual analogue scale (VAS) for pain, monofilament test sensitivity, grip strength, lateral pinch, pulp to pulp pinch and tripod pinch.

Results:

Statistical analysis was significant (p <0.05) in the progressive decline of pain and improved function (Boston) during follow-up. The sensitivity significantly improved comparing the data pre and postoperatively. The grip strength, lateral pinch, pulp to pulp pinch and tripod pinch decreased in the first month after surgery, returning to preoperative values around the third month postoperatively.

Conclusion:

The technique proved to be safe and effective in improving pain, function, and return sensitivity and strength. Level of Evidence II, Prospective study

Carpal tunnel syndrome/surgery; Median nerve; Treatment outcome; Hand strength

Variable	Follow up	Mean	St. Dev.	Median	Minimum	Maximum	p
Pain Scale	Preop. -	7.43	2.61	8	0	10	<0.001*
	1 month	3.96	3.31	4	0	10
	3 months	3.33	3.03	3	0	10
	6 months	2.46	2.96	1	0	10
Boston	Preop. -	65.99	13.57	66	33	96	<0.001*
	1 month	40.49	15.69	37.5	20	94
	3 months	33.83	13.46	31	16	79
	6 months	33.10	15.74	26	19	77
Sensitivity scale	Preop. -	2.53	0.94	3	1	5	<0.001*
	1 month	1.81	0.89	2	1	4
	3 months	1.70	0.88	1	1	4
	6 months	1.49	0.75	1	1	4

Variable	Comparison	Difference	Max diff	T	p
Pain scale	Preop. - 1 month	98.0	23.09	8.359	<0.001
	Preop. - 3 months	121.5	23.09	10.363	<0.001
	Preop. - 6 months	144.5	23.09	12.325	<0.001
	1 month - 3 months	23.5	23.09	2.004	0.046
	1 month - 6 months	46.5	23.09	3.966	<0.001
	3 months - 6 months	23.0	23.09	1.962	0.051
Boston	Preop. - 1 month	110.0	19.75	10.973	<0.001
	Preop. - 3 months	167.5	19.75	16.708	<0.001
	Preop. - 6 months	184.5	19.75	18.404	<0.001
	1 month - 3 months	57.5	19.75	5.736	<0.001
	1 month - 6 months	74.5	19.75	7.432	<0.001
	3 months - 6 months	17.0	19.75	1.696	0.091
Sensitivity scale	Preop. - 1 month	64.0	20.17	6.255	<0.001
	Preop. - 3 months	76.5	20.17	7.477	<0.001
	Preop. - 6 months	99.5	20.17	9.725	<0.001
	1 month - 3 months	12.5	20.17	1.222	0.223
	1 month - 6 months	35.5	20.17	3.470	0.001
	3 months - 6 months	23.0	20.17	2.248	0.026

Variable	Follow up	Mean	St. Dev.	Median	Minimum	Maximum	p
Grip strength	Preop.-	13.54	6.54	14	1	30	<0.001
	1 month-	10.36	4.76	10	1	27.5
	3 months-	13.04	4.97	12.8	2.5	26
	6 months-	14.65	5.57	15.25	3.8	29.5
Pulp to pulp pinch	Preop.-	2.45	1.06	2.5	0.5	5.5	<0.001
	1 month-	2.20	0.97	2	0.5	5
	3 months-	2.60	1.19	2.5	0.5	6
	6 months-	2.90	1.24	2.9	0.5	6.5
Lateral pinch	Preop. -	4.39	1.88	4.5	0.5	8.5	<0.001
	1 month-	3.65	1.57	3.5	1	7.5
	3 months-	4.29	1.69	4.1	1	8.5
	6 months-	4.90	1.75	5	0.5	9.5
Tripod pinch	Preop.-	3.09	1.37	3	0.5	6.5	<0.001
	1 month-	2.64	1.24	2.5	0.5	6
	3 months-	3.12	1.38	3	1	7
	6 months-	3.61	1.39	3.5	0.5	8

Variable	Comparison	Mean Difference	St. Deviation	p Inferior	IC (95%)
Variable	Comparison	Mean Difference	St. Deviation	p Inferior	Superior
Grip strength	Preop. - 1 month	3,18	0,61	<0,001	1,54	4,82
	Preop. - 3 months	0,50	0,69	>0,999	-1,37	2,37
	Preop. - 6 months	-1,11	0,68	0,647	-2,96	0,74
	1 month - 3 months	-2,68	0,47	<0,001	-3,95	-1,40
	1 month - 6 months	-4,29	0,58	<0,001	-5,85	-2,73
	3 months - 6 months	-1,61	0,47	0,005	-2,87	-0,35
Pulp to pulp pinch	Preop. - 1 month	0,26	0,11	0,161	-0,05	0,57
	Preop. - 3 months	-0,12	0,13	>0,999	-0,46	0,22
	Preop. - 6 months	-0,43	0,14	0,015	-0,80	-0,06
	1 month - 3 months	-0,38	0,11	0,005	-0,68	-0,09
	1 month - 6 months	-0,69	0,12	<0,001	-1,01	-0,36
	3 months - 6 months	-0,30	0,12	0,061	-0,62	0,01
Lateral pinch	Preop. - 1 month	0,73	0,19	0,002	0,20	1,26
	Preop. - 3 months	0,12	0,20	>0,999	-0,42	0,67
	Preop. - 6 months	-0,50	0,20	0,077	-1,04	0,03
	1 month - 3 months	-0,61	0,14	<0,001	-0,99	-0,22
	1 month - 6 months	-1,24	0,17	<0,001	-1,69	-0,78
	3 months - 6 months	-0,63	0,13	<0,001	-0,97	-0,29
Tripod pinch	Preop. - 1 month	0,45	0,13	0,005	0,10	0,81
	Preop. - 3 months	-0,01	0,13	>0,999	-0,36	0,33
	Preop. - 6 months	-0,50	0,14	0,003	-0,88	-0,12
	1 month - 3 months	-0,46	0,11	0,001	-0,78	-0,15
	1 month - 6 months	-0,96	0,13	<0,001	-1,30	-0,61
	3 months - 6 months	-0,49	0,11	<0,001	-0,78	-0,20

ATHA EDITORA Rua: Machado Bittencourt, 190, 4º andar - Vila Mariana - São Paulo Capital - CEP 04044-000, Telefone: 55-11-5087-9502 - São Paulo - SP - Brazil
E-mail: actaortopedicabrasileira@uol.com.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Rua Borges Lagoa, 786, Vila Clementino, São Paulo, SP, Brazil. 040036-032. aldookamura@gmail.com