수근관 증후군에서 시행한 신경외막 절제술

초록

The carpal tunnel syndrome is the most common peripheral nerve entrapment syndrome. A prospective, randomized study of epineurotomy and injection of corticosteroids as an adjunctive procedure to open transverse carpal ligament for the treatment of carpal tunnel syndrome was conducted. Fifty patients with 85 involved hands were entered into the study. After entry, all patients completed a preoperative questionnaire, and a detailed physical examination. They were followed for a minimum of 12 months. The operative findings were similar among the nonepineurotomy group(Group A), the group of those undergoing epineurotomy(Group B), and the group of those undergoing epineurotomy and injection of corticosteroids (Group C). Postoperatively, in all of the groups, improvement followed the operation(by Cseuz criteria). The two-point discrimination values for all fingers averaged 4.06 mm, 3.87 mm, and 3.97 mm in Group A, Group B, and Group C respectively. It was concluded that the epineurotomy including internal neurolysis and injection of corticosteroid following the release of transeverse carpal ligament was not more effective than the epineurotomy including internal neurolysis following the release of transeverse carpal ligament and the study data do not support the use of epineurotomy and injection of corticosteroids as an adjunctive procedure during carpal tunnel release.

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