A new study shows the effectiveness of ultrasound guidance in the treatment of carpal tunnel syndrome. Quickly reducing discomfort, this alternative is also less painful than open or endoscopic surgery.
- Performed on 61 patients affected by carpal tunnel syndrome, minimally invasive surgery guided by ultrasound has proven to be as safe and effective as traditional surgical techniques.
- It is also less painful and requires a shorter recovery time.
A common problem, especially in women between the ages of 40 and 70, carpal tunnel syndrome covers unpleasant or painful sensations in the hand that are secondary to compression of the median nerve in the wrist. Favored by the repetition of certain hand movements, such as the use of a keyboard or a computer mouse, carpal tunnel syndrome may, in the most severe cases, be treated by surgery, which essentially involves cutting the annular carpal ligament to reduce compression of the median nerve.
Two surgical techniques are generally proposed: the oldest, called “open”, consists of freeing the carpal tunnel by incising the skin of the wrist and the palm of the hand over a length of about 3 cm to cut the annular carpal ligament . For some years now, endoscopic surgery has also been proposed: the surgeon makes a small incision in the flexion crease of the wrist to introduce a tube which then allows him, via a visualization system, to cut the anterior ligament of the wrist. carp.
Although lighter than the classic operation, this technique remains invasive and painful, and most often requires recovery time.
According to a new study published in theAmerican Journal of Roentgenology, a safe, effective and less invasive alternative may soon provide relief to people suffering from carpal tunnel syndrome. Called ultrasound-guided carpal tunnel release, it would allow for faster recovery and less post-operative discomfort.
A less cumbersome and invasive operation
Developed by five researchers at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania, ultrasound-guided carpal tunnel release was evaluated on patients with carpal tunnel syndrome. Sixty-one procedures were performed under local anesthesia on 25 women and 21 men whose average age was around 60 years.
“Patients completed three questionnaires (…) assessing the function and discomfort of the affected wrist immediately before the procedure, two weeks after the procedure and at least one year after the procedure”, explains Sarah I. Kamel, first author of the study. The median scores collected show that ultrasound-guided carpal tunnel release was less painful and uncomfortable than open surgery and endoscopic surgery both two weeks and one year after the procedure.
Moreover, no immediate postoperative complications were noted even though two patients had to be operated on for complications that arose 8 to 10 days after the operation (one for infection following an injury and one for post-operative compartment syndrome). traumatic).
“The procedure now includes a more extensive pre-operative cleaning that extends to the forearm circumferentially before draping. A TegadermTM (a sterile dressing, editor’s note) is now placed in the distal third of the forearm to act as an additional sterile barrier at the edge of the sterile field. In addition, two passes of the ligament section are routinely performed on all patients to potentially reduce the risk of tissue remnants contributing to incomplete release.”said Dr. Kamel.
Further research is still needed to ensure the safety of this new procedure.
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