RESUMEN
Carpal tunnel syndrome is treated very successfully by surgical release of the flexor retinaculum. However, in some patients, all symptoms are not resolved. Weakness in grip strength and pain in the thenar and hypothenar areas corresponding to the end of the transverse ligament after its complete section have been described as common complications of classical neurolysis of the median nerve. This study presents here the long-term results of decompression operation of the median nerve at the wrist, conserving the transverse ligament, as well as its comparison with the classical open neurolysis with a complete section of the ligament. This is an analysis of a retrospective cohort of 114 patients, who were operated on for carpal tunnel syndrome. A clinical, electromyographic, and dynamometric evaluation of the patients studied was carried out in a comparative analysis of the surgical techniques used (flexor retinaculum lengthening according to the Simonetta technique and classical open neurolysis of the median nerve), in a period of 10 years after the operation. The ligamentoplasty technique, in the long-term, contributes to better results of manual force, with a smaller resolution of tingling sensations than the neurolysis with complete section of the transverse ligament. For those patients who do not present a severe clinical or electromyographic syndrome, and in addition require manual effort for their daily activities, the technique of ligamentoplasty, according to Simonetta, is a surgical option to be taken into account.
Asunto(s)
Síndrome del Túnel Carpiano/cirugía , Descompresión Quirúrgica/métodos , Fuerza de la Mano , Ligamentos Articulares/cirugía , Adulto , Síndrome del Túnel Carpiano/diagnóstico , Estudios de Cohortes , Electromiografía/métodos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Rango del Movimiento Articular/fisiología , Estudios Retrospectivos , Medición de Riesgo , Índice de Severidad de la Enfermedad , Factores de Tiempo , Resultado del Tratamiento , Articulación de la Muñeca/cirugíaRESUMEN
PURPOSE: Surgical treatment options for medial compartment osteoarthritis of the knee include high tibial osteotomy, total knee arthroplasty or unicompartmental knee arthroplasty (UKA), depending on the patient's age, level of physical activity and the degree of deformity. METHODS: In this study, we evaluated the long-term results of patients who underwent the Oxford cemented meniscal-bearing unicondylar knee prosthesis through a minimally invasive approach including a clinical, functional and radiographic assessment. RESULTS: Favourable clinical and radiological outcomes were registered overall at ten years after surgery. Overall results of UKA according to the American Knee Society (AKS) using Insall's criteria showed an excellent or good outcome for 492 knees (96.28 %), fair for 11 (2.15 %) and poor for eight (1.57 %) in the post-operative long term. CONCLUSIONS: We believe that with appropriate surgical technique, patient selection, prosthetic design and specific training, surgeons should achieve good outcomes with the added advantages of a minimally invasive approach. High volume for this technique is important in our opinion.