کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4070064 1604418 2010 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Sonographic Follow-Up of Patients With Carpal Tunnel Syndrome Undergoing Surgical or Nonsurgical Treatment: Prospective Cohort Study
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی ارتوپدی، پزشکی ورزشی و توانبخشی
پیش نمایش صفحه اول مقاله
Sonographic Follow-Up of Patients With Carpal Tunnel Syndrome Undergoing Surgical or Nonsurgical Treatment: Prospective Cohort Study
چکیده انگلیسی

PurposeTo compare changes in the largest cross-sectional area (CSA) of the median nerve in wrists undergoing surgical decompression with changes in wrists undergoing non-surgical treatment of carpal tunnel syndrome (CTS).MethodsThis study was a prospective cohort study in 55 consecutive patients with 78 wrists with established CTS, including 60 wrists treated with surgical decompression and 18 wrists with non-surgical treatment. A sonographic examination was scheduled before and 4 months after initiation of treatment. We compared changes in CSA of the median nerve between wrists with surgical treatment and wrists with non-surgical treatment using linear regression models.ResultsDecreases in CSA of the median nerve were more pronounced in wrists with CTS release than in wrists undergoing nonsurgical treatment (difference in means, 1.0 mm2; 95% confidence interval, 0.3–1.8 mm2). Results were robust to the adjustment for age, gender, and neurological severity at baseline. Among wrists with CTS release, those with postoperative CSA of 10 mm2 or less tended to have better clinical outcomes than those with postoperative CSA of greater than 10 mm2 (p=.055). Postoperative sonographic workup in the 3 patients with unfavorable outcome or recurrence identified likely causes for treatment failure in 2 patients.ConclusionsIn this observational study, surgical decompression was associated with a greater decrease in median nerve CSA than was nonsurgical treatment. Smaller postoperative CSAs may be associated with better clinical outcomes. Additional randomized trials are necessary to determine the optimal treatment strategy in different subgroups of patients with CTS.Type of study/level of evidenceTherapeutic III.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Hand Surgery - Volume 35, Issue 9, September 2010, Pages 1401–1409
نویسندگان
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