Epineurotomy in the treatment of carpal tunnel syndrome ; is it necessary ?

الملخص EN

This prospective randomized clinical study included 50 hands (44 patients) that were treated operatively from July 2000 through August 2002.

The criteria for inclusion were clinical- signs and symptoms of dysfunction of the median nerve in the carpal canal that were not responsive to no operative treatment.

The hands were chosen randomly to receive one of the two types of treatment: operative decompression of the median nerve alone(group 1) or operative decompression of the medial nerve and longitudinal opening of the epineurium in the region of the carpal canal (group 2).

The patients were evaluated 12 months postoperatively, and all of the patients had an EMG study performed both preoperatively and at 12 months postoperatively.

22 patients (25 hands) were randomly assigned to Group1 (no epineurotomy) while 22 patients (25 hands) were randomized to Group 2 (epineurotomy).

At the 12-month follow-up evaluation,16 hands inGroup1 and 15 hands in Group 2 no longer had any symptoms of median nerve dysfunction.

With the numbers available for the study, the difference was shown to be insignificant.

There is no difference in outcome when an adjuvant epineurotomy is performed compared with when a ligament release is performed alone for the most advanced forms of carpal tunnel syndrome.