CLINICAL ANATOMY OF THE CARPAL TUNNEL IN PRIMARY COMPRESSION OF MEDIAN NERVE (CARPAL SYNDROME)
The carpal tunnel syndrome (CTS) is a symptomatic compression neuropathy of the median nerve at the carpal level. It is based on the increase of the intraluminal pressure in the carpal canal with malfunction of the median nerve. The treatment of CTS can be conservative and surgical. The surgical treatment consists in decompression of the median nerve in the carpal canal by an open, minimally invasive, or endoscopic method. Many up-to-date studies demonstrate the higher efficiency of the operative treatment of CTS in comparison with the conservative methods in the long term. However, all the studies ignore the early postoperative period. Our study was carried out with CTS patients (n = 60) with the II stage of disease by the R. Szabo classification (1992) aged from 18 to 75 and electroneurographic signs of compression of the median nerve in the carpal canal. Depending on the decompression method (open or endoscopic), the patients were divided into two groups each consisting of 30 patients. To estimate the efficiency, the sonographic pattern of the median nerve in CTS patients was analyzed before and after different versions of surgical decompression. Peculiarities of recovery of palm functions after different versions of surgical decompression of the median nerve were analyzed with the DASH enquirer, and the intensity of the postsurgical pain syndrome was examined. It is proved that the sonographic pattern of the median nerve at primary CTS shows itself as an intraneural edema and an increase in the cross section area of the nerve. Regardless of the method of decompression, the significant regress of the neural edema is observed by the 14th day in the postsurgical period. The open and endoscopic decompression of the median nerve in the carpal canalat primary CTS in the early postsurgical period are identically efficient for decrease in the neuropathic pain level and recovery of palm functions. However, because of minimal injury, endoscopic decompression is easier for patients and requires smaller amounts of anesthetics
Keywords
синдром запястного канала,
синдром карпального канала,
срединный нерв,
деком- прессия,
кисть,
Carpal tunnel syndrome,
median nerve,
decompression,
handAuthors
| Baytinger A.V. | Krasnoyarsk State Medical University named after Prof. V.F. Voyno-Yasenetsky | drbaitinger@gmail.com |
| Cherdancev D.V. | Krasnoyarsk State Medical University named after Prof. V.F. Voyno-Yasenetsky | |
| Rybakov V.E. | Siberian State Medical University | |
Всего: 3
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