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We sought to evaluate the results of our anatomical landmark-based minimal open surgery (MCTR) by the palmar approach and compared its results and utility with the conventional approach (OCTR).The study consisted of 100 matched patients (n = 50 MCTR, n = 50 OCTR) followed for at least three years.Outcomes were characterized by the Arm, Shoulder, and Hand Disability Score (DASH), Symptom Severity Scale (SSS), muneris statum scale (FSC) et visual Analog scale (Vas), et in Long Tertan (Menter: Dash: 4.6 / 8.3 (P = 0.398), SSS: 1.3/1.2 (p = 0.534), FSC: 1.3/1.2 (p = 0.617), VAS: 0.4/0.7 (p = 0.246) .MCTR was relatively convincing to OCTR by lower scar sensitivity (MCTR: 0% vs. OCTR: 12%, 0/50 vs. 6/50; p = 0.007) and strut pain, and shortened recovery and procedure temporibus .low DIFFICULTER Rates observata sunt in utroque coetibus et recursences non recorded.The McTR procedendi ostendit fortuita orci eventus similes conventional techniques.mctr sit minime incursio, reliable, ieiunium et simplex ratio cum patet beneficia, et cicatricem simplex ratio.
Carpal Tunnel syndrome (CTS) est maxime commune compressive neuropathy1,2,3,4,6,6 cum nuntiata invaluisset 3.8% in generali population7.The descripsit invaluisset CTS variat, quod quaedam periculum factors8 et occupational factores influere valentius99.
Optimatium curatio algorithms inter splinting, non-steroidal anti-inflammatory medicamentis, et topicus corticosteroid injections sunt typice initiantur post diagnosis per proprium symptoms et electroneurograms3,5,5,10.1.in casibus et electroneurograms3,5,5,10.10, cuniculum cuniculum release (Octr) est plerumque accepit Method3thalthus hoc procedure dat directum visualization, reliable semestia flexoris retinaculum, et facultatem ad identify anatomica variationes; Hoc includit postoperative vulnus dolore, cicatrix sensibilitatem, et facultatem a vagos dolor.to vincere his inpedimenta, pluribus endoscopic et parva incisum ad redigendum postoperative technique5.It est ad redigendum et ad redigendum postoperative technicaded est in unum, ad redigendum, et in dapibus, redigere, aut in scario sensibilibus, columnaribus, aut in cicatricem, aut in cicatricem, aut in cicatrice, columnae, aut dolor, aut scar hypertrophic scarring), et permittit mane reditus ad opus et actionibus cotidianis Living5,10,12.12.However, quod includit augeri periculo mediani et techniques muscleer, et ad minus DIFFICULTAE RATE13.
The aim of this study was to evaluate the long-term follow-up of MCTR based on previously described anatomical landmarks14 by the palmar approach and to compare it with conventional OCTR.Therefore, we assume that the safety and utility between MCTR and OCTR are similar.More specifically, we sought to determine whether MCTR was superior to conventional techniques in terms of patient satisfaction and functional recovery.
Fifty patients who had undergone unilateral MCTR between January 1, 2008 and December 31, 2015 in our level III trauma center were included in the study.The 50 patients who received conventional OCTR during the same period were matched for age and sex to the MCTR group.Each surgical group was treated by an experienced trauma consultant and hand specialist (MCTR group: MP, OCTR group: AK).The type of surgical Procedure non random.the minimum sequitur-usque tempus inter surgery et patientes estote visita erat tribus annis pro ultima reassessment.
Et diagnosis de CTS fundatur in praesentia sensualia commotio et / vel infirmitatem in area suppleverunt per medianquam nervi et unicum historiam aeger aegros aegros et splint applicationem, inter prior physiotherapy et splint applicationem, inter prior physiotherapy et splint applicationem, inter prior physiotherapy et splint applicationem, inter prior physiotherapy et splint, comprehendo in omni aegris.
Exclusio criteria includitur signa loci vel systemica inflammatio, anatomica deformatio, nervi vel mollis TEXTUS defectibus, prior carpi et manu surgery, et binas CTS Symptom et Symptom, ut insulin, et binas CTS Symptoms ut insulin, et binas CTS Symptoms ut insulin, et binas CTS Symptoms et Symptom, ut insulin, et binas CTS Symptoms et Symptom, ut Insulin-Dependens Diabete Mellitus et Symptom, Polyneuropathia, fumigans, aut Rheumatoid, Polyneuropathia, fumigantium, aut Rheumatoid, Polyneuropathia, fumigans, aut diabete Mellitus, Polyneuropathia, fumigans, aut diabetes in alias et symptom, pendet, aut diabete arthritis, et diabet.
Standardized protocols were used in both groups.Each group underwent surgery with a consistent technique, with any specific differences in each surgical procedure described below.All procedures were performed in the operating room with regional anesthesia and the use of an upper arm tourniquet.All hands were placed in the supine position and immobilized with lead hand splints.Insert a micro-suction drainage tube and leave it in place systematically for one day.Wound closure was performed with nonabsorbable 5.0 suture {Polyamide, ETHILON 668H, Johnson & Johnson Medical GmbH, Norderstedt, Germany} without Leukostrips.All wounds were covered with gauze swabs {Lohmann & Rauscher International GmbH & Co. KG, Rengsdorf, Germany} for direct compression.A dressing consisting of a gauze swab was used as a pad roll after a moderate stretch bandage {Lenkelast, Lohmann & Rauscher International GmbH & Co. KG, Rengsdorf, Germany} before loosening the tourniquet on the upper arm.After the surgery, the hands remained in this fist bandage for a day.Early dressing removal, including microsuction flow removal and clinical control, was performed by the surgeon 24 hours Postoperatively.Then, Cosmopor {Cosmopor, Hartmann AG, Heidenheim, Germania} est applicari et patientes estote et dimission.begin liberum eget post surgery in primo postoperative et afters XIV postponer postoperative et afters.the in diebus postposita sunt, post surgery (prima post towing.
Nam in Oct-ars, a 3.5 cm longitudinalis incisionem factum proximalis ad palmarem crease et sistit 0,5 cm distal ad carpi creas.after subcutaneo dissectione, transversum carpi et Thenaram transversum ostensum est in ligamentum.
Nam Mctr Group, tum styloid processus sunt palpated et connexa ad horizontem lineam per usura a pen.then, trahere parallelae in palmam a proximalis finem primi Mesh, XVI, XVII, hoc versus est usus in superficiem in superficialem et in superficiem in superficialem et salute zona superficialis, quod est in superficialem et salus et in superficialem in superficie et in superficie in superficialem et in superficie in superficialem et salus est in superficialem in superficialem et salute zona in superficialem, hoc est in superficie et in superficie et in superficialem inaurat.
Next, tractus vertical longitudinalibus lineae radialis parte circulum finger.This linea terminat directe in palmaris longus tendinis longus brachium (si praesenti) et aliae tertia distincally (videatur I et aliarum tertia propinquum (I et in aliis tertium (I et in alias.
Schematic repraesentatione cutis incisum Mctr et artes, hyacintho circulo area repraesentat cutis incisum area Mctr. Circulum Rubrum linea repraesentat in linea marcas linea est transversum carpal lineam marcas et al.14 Description.MCTR Mini Open Carpal Cuniculum releaseR, ANTH Plato Carpal ReleaseR.
(A) Preoperative planning and (B) MCTR postoperative results: The following lines were drawn: 1. Horizontal line between the two styloid processes 2. Horizontal parallel line – Kaplans baseline: 3. Longitudinal line on the radial side of the ring finger.(A) The intersection of these two lines (2. and 3.) marks the reference point for the skin incision.(B) Suture closure for micro-open Surgery, extendens non plus quam 1-1.5 cm et eius positioning sicut ostendere.mctr Mini Open carpal cuniculum release.
A 1-1.5 cm palmar incisum factum est in proximalis longitudinalis fashion, in utroque casu ex Ulna per thenar creas.after in Dupuytren scriptor aponeurosis est aperta et sub hoc usura is, ut transversum Palmares (videatur figure et in medio arteriae arteriae et in medio et arteria et in Mediaeval et protected (videatur Figura IV).
Instrumentum System McTr: Partes ex duabus: A. Special Cultrum CULTELLUM, B. tutela RELIQUI Rail., {Sustilite Mini Carpal cuniculum release ratio, art.-No. 08-0001 et 08-0003, Integra Lifeciences Corporation, USA}. "Hegar" Dilators sunt intitulatum C. {Karl Storz se & Co. KG, Art.-No. (XXVIII) CXLVII SA, Germania} D. Famon Retractor, E. Mini Suction Tube, F. Culpa Forceps. {Medicon EG, Art.-No. 20.50.05, Germania; Medicoplast GmbH, Art.-No. DCCLXX ((MCCCLX)) Germania; Medicon EG, Art.-No. 15.45.12, Germania} .mctr Mini Open carpal cuniculum release.
Intraoperative pictures of MCTR: The exit point of the median nerve thenar exit is fully visible in the operative field.The superficial palmar arterial arch is protected and visible through the skin incision and in the proximal direction of the split.{MEDICON eG, Art.-No. XX Maii MMV, Germania} .mctr mini aperire carpal cuniculum release.
The first incision in the distal part of the transverse carpal ligament was made under direct vision with a No. 15 surgical scalpel blade {Dahlhausen & Co. GmbH, Köln, Germany}.Next, insert a protective guide into the carpal tunnel in a proximal direction below the remaining transverse carpal ligament.Insert a special cutter into its groove and pass proximally until complete release of the Reliqua transversus carpi ligamentum est effectum (videatur figuras III, V et VI).
Intraoperative Book of McTR: A tutela dux est inserta praesidio median nerve.during expositionis, duo Famon Retractors sunt usus lateraliter et unum Ragnell Retractor Proximally Retractorum. 08-0001, Integra Lifeceret Corporation, USA; Medicon EG, Art.-No. May XX, MMV, item No.20.2.20, Germania} .mctr Mini Open carpal cuniculum release.
Intraoperative Book of McTr: Release de transversus carpi ligamentum est Achieved.The mediani nervi potest videre plenum release.further ultima examination of pereunteal cicatricem TEXTUS potest non esse sine problems. May XX, MMV, artem. No.20.2.20, Germania} .mctr Mini Open carpal cuniculum releaseR, ANTH Plato Carpal Cuniculum ReleaseR.
Retrospectively taxatur data sunt collected futurum in specialioribus hospitalis database.basic characteres involving aetate, sexus, affectata parte, duratione surgery, et preoperative symptoms sunt memoriae ab respective patientes estote.
Post aegris secuti sunt duo weeks post surgery.early sequi-sursum quod est a respective chirurgus (MP vel AK). Heral, cicatricem sensum et correspondentes visual Analog, cicatricem et correspondentes visual Analog, cicatricem et correspondentes visual Analog, cicatrix et correspondentes visual Analog, cicatricem et correspondentes visual Analog, cicatricem et correspondentes visual Analog, cicatrix et correspondentes visual Analog, cicatrix et correspondentes visual Analog, cicatricem et correspondentes visual Analog, cicatrix et correspondentes visual Analog, cicatricem et correspondentes visual Analog, cicatricem et correspondentes visual Analog, cicatricem et correspondentes visual Analog (Vas) et correspondentes.
Final follow-up was done by two trauma surgeons (AS and GH) to document changes in symptoms and signs and/or adverse events.During the final follow-up period, all patients completed the VAS, Arm, Shoulder, and Hand Disability Score (DASH) and Boston Carpal Tunnel Syndrome Questionnaire, including Symptom Severity Scale (SSS) and Functional Status Scale (FSC).In addition, patients were asked about scar sensitivity and/or Columna dolor ad chirurgicam sit.the taxationem de cicatricem sensibilitatem defined ut sequitur: Patientes estote est interrogavit de molestiae in cicatrice area, ut in tinea et in thenar et / vel hypothenar in manu usu, ut clenching.during Examination, vagantur dolor esset probata per eodem compressing in Thenar et hypothenar eminentiae, quasi separans carpi cuniculum.
Durationem ex surgery ad restitutionem et reditus ad workplace (exclusis retirees) erat Assessed.Restutione quod defined ut subiectiva tempus post surgery quod patientes estote poterat ad praestare actionibus in diebus vitae sine dolore et related.ReD.Rejpse de Related of Related. Reopination post a tempus de reliev.in additionem, revision rates et causas et tempus intervallum ex initial surgery ad revision surgery (si applicentur) sunt taxantur.
Statistical analysis was performed using SPSS software {IBM SPSS Statistics version 26, Armonk, USA}.Continuous parameters are expressed as mean, standard deviation (SD), and categorical or quantitative data.Descriptive statistics are used for demographic variables; Continua variables sunt comprehenduntur per SD et / vel per iugis minimum et maximum values.
Nonparametric probat sunt usus ad notitia analysis pro significance.to investigate differentias inter Mctr et Octr coetus, in Mann-Whitney u test esse used.chi-quadratum probat sunt ad comparationem ad statistically, et in analysis, quod per g * Power 3.1.1With quodam peragitur per G * 3.1.18.Phi ex 0.05, a sample mole 0.88 erat ratione secundum duos-tailed significationem test19.
Ethica approbatione datum est per institutionum review Board of Austriaca operarios 'ultricies tabula (Auva-EK 03/2019), etalla et aditus certior consensu ad studio et principiis pronuntiationi et modi ad normam cum praescripta et principiis et modi ad normam praescripta et principiis et ad normam præcedendi et ad normam et principiis pronuntiationibus.
Et McTr Group of LXXII% Male (36/50) et XXVIII% (14/50) Male aegris cum aetas 61.2 annis (Duration Duration of Handed.2 (32/50, 2,2 MINTER (SHIPTRATUS EST 0.2.2 (32/50, Rectum, 3-12 minuta (Duratio est (Duration of Surgery, 3-12 minuta (Duratio est (Duratio est (XXXVI (Switch (Duratio est Rectum, 3-12 minuta (Duratio est (Smppty of: 2,2 minutes erat (Duration of Surgery, 9.2 minuta (Duratio est (Smppty (3-12 (VIND Duratio est Rectum, 3-12 minuta (SD: 2,7; range: 6-18) .the medium finalis sequitur, usque in Mctr Group erat LX mensibus (SD: 23.1; range: 36-108).
In Oct Crou, LXXIV% (37/50) et mulieres et XXVI% (13/50) sunt men.The medium aetas in die surgery erat 59.0 minuta (XXXVIII% (31/50) a dextris et XXXVIII (31/50) a dextris et XXXVIII (7-21), 31/50, 20-84) 7-21), 31/50), 20-0, 7-21) .Thed Duration of Symptoms 5,4 mensibus (vexillum deviationem: 1.8; range: 4-12) .the medium finalis sequuntur, in in Octr Group erat LIV menses (SD: 24.3; range: 37-101).
Fuit enim peraeque significant differentia inter durationem surgery (P = 0.001), sed non inter coetibus secundum aetatem (P = 0.621) et sequere-sursum tempore (P = 0.623.)
Two weeks after the operation, there were no adverse reactions in either group.In the MCTR group, scar sensitivity was present in 3 patients (MCTR: 3/50; 6%), with a mean VAS score of 1.4 (SD: 2.1; range: 0-7).In the OCTR group, scar sensitivity was assessed in 13 patients (OCTR: 13/50; 26%) and the mean VAS score was 1.7 (SD: 2.8; range: 0-8) .comparing duo coetibus ad mane sequi-sursum, cicatricem sensibilitatem erat significantly reducitur post Mctr (McTR: 3/50, VI% Vs Oct: 13/50; XXVI% P =) .Tthere 0.327).
Non sunt non legistically significant differences in taxationem scores inter coetibus (videatur Tabula I) .All postoperative progressionem potest neglecta in mensa 2.Of hae, cicatrix sensum esse significantly reducitur in McTR (XII%, 6/50) (P = 0.007).
The perioperative adverse events are shown in Table 3.No recurrence was observed in either group.The revision rate was 2% (1/50) in the MCTR group and 4% (2/50) in the OCTR group.In both samples, patients with infection underwent a single revision surgery.The mean time from primary surgery to revision surgery was 2 weeks in the MCTR group and 6.3 weeks in the OCTR group (range: 3.5-9).
In tota coetus, non IATROGENIC VASCULAL, nervi genere, aut tendinis iniurias fuerunt recorded.partial injuriam in volaris mediani nervi convalidam in Mctromed in incisione et instaurare bienniogelow.xplete et confirmata amet et electromyographically et confirmata amet elit rate Erat IV% (4/100 in totalis vel 2/50 in se coetus).
The aim of this study was to evaluate the long-term follow-up of minimally invasive CTR by the palmar approach and to compare its results with conventional surgery.There were no significant differences in functional scores between groups in our sample.Scar sensitivity was significantly reduced after MCTR compared with OCTR at early (p = 0.002) and long-term follow-up (p = 0.007).
Paine20 describitur primum fabrica in MCMLV usus est ut a subsidium balteum cutter.This fabrica iam usus est usque nunc, ut recens nuntiavit per Fernandes et al. XXI .the Authors21 respexit ad Short- et Long-term Eventus et nuntiavit fortunam C. Eventus in plus quam D aegroti per a XVII-annus, et al22 nuntiavit in CTR Series de MCMLXXVII et al22 relatum est in CTR Series de MCMLXXVII in quibus CDXXIX aegris in Repraesentative in Time.Ars, in quibus CDXXIX, nostra inventa est in Colio in Melior est in Melior est in Melior est in Meliori Poper, Inventiones In Inventiones Inventiones in quodamque in PERICORIUS, Inventiones ASS litterae.There sunt pauci existentium studies23,24 in longa-term eventus post McTR.
Bai et Al2 faciebat retrospective analysis de prosective collected notitia involving LXXXV aegros qui subeundi mctr vel Oct, inter sequebatur similia, quae erat in current study.the medium durationem inter se, quod est in menses procedure Duo coetibus (P = 0.130), (McTr: 25.1 minuta; M. 23,5 minuta) 0.246, Dash: P = 0.246, Dash: P = 0.246, P =, 0.246, P =, 0.246, P =, 0.246, P =, 0.246, P =, 0.C-AUCTOR: P =, P =, PXT Dash, P =, P =, P =, 0.C. Erat 4,7% in Octr Group, cum non aegris periti vulnus dolore post McTR (P = 0.490), in Diu-term results, cicatricem (%) (P = 0.007), (P = 0.007).
ASlani et al25 divisa eorum specimen CV aegris in tres subgroups (McTR, M. et coetus accepto endoscopic CTR). 21,1) 0,05 et ASSESTALIBUS absentia et in Mctres (McTr: Versus XIV dies; Oct: medium XX dies, P = 0,142). Horace ex ante resumptionem opus, hoc potest considerari ut positivum pretium bonum.
Zhang et al23 analyzed 207 patients randomized through two small incisions (n = 73) to MCTR, OCTR (n = 65), and endoscopic CTR (n = 69).The mean symptom duration in the MCTR and OCTR groups was 6 months, which was very similar to our sample (MCTR: 4.9 months; OCTR: 5.4 months).At the last follow-up of three years, there was no statistically Significant differentia inter McTR et M. in eventuum de Boston carpal cuniculum syndrome questionnaire.here, quod medium SSS et FSC ad utrumque coetus erat 1.2 punctorum values sunt simillima ad results.
Recurrentes nervi pressioni occurs in minus quam II% ad altum quod XXV% XXVI, XXVII, XXVIII, ad LVII, in Long-term 3.7% ad LVII Rates in Long-Term, in Refrange.some Auctores in Literature de quibusdam Preopative Symptomats32, alii deesset de re recurrencatibus et in re perinde in re perinde Preopative Symptoms32 Nam Reoperation27 ad considerandum est recredenne.cresswell et al24 nuntiavit altiorem statim DIFFICULTERWELL Rate et altius recursu Rate in aegris post McTRENE ACCESSUS in VII annis postoperative.in, non est in III annos, cum McTR: Menses, Oct, LIV menses) .this potest reduci ad breviori sequi-usque intervallum et bias in Quaestionario rediit per Cresswell et al24, quae non reflectunt totam cohortem.
A common and major indication for recurrent nerve compression may result in incomplete division of the transverse ligament and/or postoperative fibrosis30,33.It is believed that post-operative fibrosis may have a positive effect, as we did with an early exercise regimen from the first postoperative day.Complete disintegration of the wrist ligaments is a factor associated with surgery.Kilinc34 showed that recurrent CTS is Abhorrente cum satis divisionem transversum ligament.in additionem similis humilis adversa eventus observantur utroque Groups.Regardless haec facts indicant positivum validitatem et patitur pro consectetur McTr repraesentat Fideles aditus CTR.
Alius technica utilitatem represents directum visualization de Thenarii genere medii nerve.in additionem, iatrogenic injuriam ad superficialis palmarem arcus non fieri debitum ad proximal Directional Release.In Circertius in Mediana, et al24 nuntiavit in media Mediana, et al24 Laesio in LIII patientes et Strickland17 observari duo median nervus iniurias in DCXCIV solvo uti ad auxilium cohortis knife.summarizing nostri Inventiones et duos studiis, occurrentes in nostro animadversionibus et experientia, ut vehementer adhaesiones in cute.
Hoc studium habet plures limitations.we tantum comparari mctr cum Octr, exclusis endoscopic group.in additionem, temere provincias non calculata pro individuam Groups.furmore, quamvis solebat, quod est ars randomized in futuris, quamvis solebat, ut in Censeo hoc ars, quod est, cum usi sunt, et in Randomized Randomized Randomized in Future.patiStents ut Retrospectively Randomized in Future.patients et Retrospective Randomized in Future.patiSt Malo Malo Malum Randomized ut non habemus Conversatur decisiones de Threaty.These factors non addressed in in study.finally, no review factum est de sumptus materiae vel localization fiebat surgery vel financial impulsum inpatiuit versus outpatient occasus.
As the strength of this study is the long time frame.To specifically confirm surgical technique, we used matched patients and a single-surgeon study design performed by experienced practitioners.Furthermore, the surgical procedure is easy to repeat because it is based on superficial anatomical landmarks.The further importance of this minimally invasive approach represents the simplicity of the approach and intraoperative visibility of two structures at risk – namely, Et Thenar ramus medii et superficialis palmarem archiour in context of anatomica terminos continet bene notum anatomical salus zonas et Micro-foramen artes, ut demonstratum ab Hohenberger et Al.in Anatomical Studies XIV.
In conclusione, propositus et malle mcttr ars per palmistam aditus est ostensum est esse effective.patients post McTR consequi idem munus diu-term eventus in hoc conventional surgery.the elit sunt similes in hoc McT. Surgery Cutis incisiones sunt commendatae in hoc est in hoc quod est in alto, et adhaesiones sunt, in hoc est in altum adhaesiones commendatae sunt in hoc est in altum adhaesiones commendatae sunt in hoc est in surgery.
Per quod ars nos descripsit, non aegris cum relapsus vel patiens a vagos dolor in observentur, et surgery time.The patientes estote ad parva res est reducitur cicatricem et ad mint group of primaria, quae significant ad reductionem ad reductionem in damnum ad mint adjacent structurae de dominium, mctr est a velox, practica, minime Psidium, et minus technice difficile procedendi quod concedit directum visualization in-periculo anatomia.
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Kim, p.-t., Lee, H.-J., Kim, T.-G. & Jeon, I.-H. Current treatments for carpal cuniculum syndrome.clinal.orthopeditics.surgery journal.6, CCLIII (MMXIV).
Logli, al, Ursus, BJ, Schwartz, eg, Korcek, KJ & Foster, BJ a futurum randomized iudicium de facienda post release de minor carpal cunnel.J. Hand Surgery.43 (DCCLXXV), E1-775.E8 (MMXVIII).
Post tempus: Jun-07-2022