Karpal tünelin açık cerrahi yöntem ile gevşetilmesi sonrasında transvers karpal ligamanın ultrasonografik değerlendirmesi

Abstract

Amaç: Bu çalışmanın amacı karpal tünel sendromu (KTS) tedavisi için yapılan açık yöntem ile gevşetme cerrahisi sonrası transvers karpal ligamanda (TKL) meydana gelen değişikliklerin ultrasonografik olarak incelenmesi yeterli miktarda kesilmiş TKL tanısı için ultrasonografik kıstasların oluşturulması idi. Çalışma planı: Açık cerrahi yöntem ile gevşetme yapılan 36 KTS’li hasta prospektif olarak incelendi. Hastalar fizik muayane ve ultrasonografi ile cerrahi işlem öncesinde ve sonrasında değerlendirildi. Bulgular: Cerrahi işlem sonrasında tüm hastaların şikayetlerinin ortadan kalktığı görüldü. Cerrahi sonrası TKL’nin düzgün formunu kaybettiği ve diffüz olarak kalınlaştığı görüldü. Cerrahi sonrası kalınlığın cerrahi öncesine göre istatistiksel olarak anlamlı şekilde artmış olduğu saptandı (p<0.05). Çıkarımlar: Ultrasonografi, açık yöntem ile yapılan gevşetme cerrahisi sonrasında TKL’yi yeterli derecede değerlendirebilecek bir görüntüleme yöntemidir. Ayrıca, ultrason, cerrahi gevşetme sonrasında şikayetleri geçmeyen olgularda yetersiz kesilmiş TKL tanısını dışlamada yardımcı bir yöntem olarak kullanılabilir.

Keywords

• Karpal tünel sendromu; transvers karpal ligaman; ultrason.

Sonographic assessment of transverse carpal ligament after open surgical release of the carpal tunnel

Abstract

Objective: The aim of this study was to sonographically evaluate the anatomy of the transverse carpal ligament (TCL) after open surgical release in the treatment of carpal tunnel syndrome (CTS) and to establish new ultrasonographic criteria for the completeness of TCL release.
Methods: Thirty-six patients who underwent open surgical release for CTS were recruited prospectively. Patients were evaluated with physical examination and ultrasonography before and after the operation.
Results: All patients’ symptoms resolved after surgery. TCL was found to be diffusely thickened and to have lost its smooth form after surgery. Postoperative TCL thickness showed a statistically significant increase when compared with preoperative values (p<0.05).
Conclusion: Sonography is a capable imaging method for assessment of the TCL after open release surgery. In addition, ultrasound may be considered as a complementary tool to exclude diagnosis of incomplete transection of TCL in patients with persistent symptoms.

Keywords

• Carpal tunnel syndrome
• sonography
• transverse carpal ligament
• ultrasound

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