VOLUME SELECTION OF SURGICAL TREATMENT IN PATIENTS WITH CARPAL TUNNEL SYNDROME

Abstract

Carpal tunnel syndrome CTS most often occurs among compression neuropathies and tunnel syndromes of the upper limb. The existence of many surgical treatment methods indicates the need for an individual approach in their implementation. The purpose of the paper is to clarify the determining factors for the best intervention in terms of the scope and to evaluate the eff ectiveness of proposed principles. Materials and methods. We observed 52 patients with carpal tunnel syndrome with unsuccessful conservative treatment; electroneuromyographic and ultrasound signs of gross changes in the structures of the carpal tunnel. There were 19 men and 33 women (36.5% and 63.5%, respectively). In all patients, the intervention started with a 2.5 cm access and revision of the carpal tunnel structures. In cases where their gross anatomical changes were verifi ed, the access was expanded to 5-5.5 cm and the intervention was performed not only on the carpal ligament but also on altered structures using microsurgical techniques and optical magnifi cation. Results. The dynamics of indicators of the Boston BCTQ questionnaire and the VAS were in full agreement with the degree of anatomical and functional disorders. This trend persisted after 4 weeks, and by the 3rd and 6th months, the results were close and, in the end, practically did not diff er. Conclusions. Carpal tunnel syndrome is the most common of compression neuropathies and upper limb tunnel syndromes. Surgical treatments are diverse. Clarifi cations of the indications for using each of them will allow personalizing the intervention.