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ISSN 2992-779X (Electronic)
ISSN 2007-6452 (Print)

2018, Number 3

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Investigación en Discapacidad 2018; 7 (3)

Functional Results after Carpal Tunnel Endoscopic Release on a Public Health Out-Patient Surgical Campaign

Farías-Cisneros E, Valencia-Rodríguez DF, León-Hernández SR, Avilés-Heredia LA, Espinosa-Gutiérrez A

Language: English
References: 47
Page: 73-90
PDF size: 951.20 Kb.


ABSTRACT

Purpose. Carpal tunnel syndrome (CTS) is the most common type of compressive neuropathy. Its main manifestations are paresthesias and dysesthesias over the median nerve territory on the hand. CTS is a ubiquitous public health problem and frequently causes disability. Endoscopic release is a good alternative to CTS. We aim to evaluate both the benefits of CTS diagnosis in the primary care system, and the benefits of using an outpatient surgery for CTS. An additional goal was to generate current national statistics regarding early diagnosis, functional outcome, and prognosis of median nerve compression treated with endoscopic carpal tunnel release (ECTR). Methods. In a collaboration with Mexican public health institutions, we designed a self-controlled, longitudinal, prospective study focusing on the early detection and surgical treatment of CTS. A preoperative assessment was conducted on 56 patients based on medical history, physical exam-ination, dynamometry, and functional scales including DASH, Mayo, Michigan, and visual pain analog. Thirty-six adult patients were treated surgically with ECTR and followed for up to 16 months. Results. All study time points were collected on 23 patients. This self-controlled study showed statistical improvements in pain symptoms (92.4%, p 0.0001), muscle strength, and functional questionnaires DASH (66.1%, p 0.0001), Mayo (48.2%, p 0.001) and Michigan (91.3%, p 0.0001) in patients treated with ECTR compared to patients’ baseline measurements before surgery. At the second follow-up visit, only one complication was reported in the 36 patients with follow-up data. Conclusion. ECTR shortened the recovery time and improved functional out-comes in patients. While more clinical research is needed to fully demonstrate the utility of ECTR for treatment of CTS in public health cases, this study showed that lack of access to tertiary care hospitals is not an impediment to providing CTS treatment. Implementation of training programs at local hospitals with up-to-date training on diagnostics and treatment improves the prognosis of patients with CTS.


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