Analysis Of Efficacy And Clinical Experience In Open Carpal Tunnel Release For Treatment Of The Carpal Tunnel Syndrome.

objectve To discuss the efficacy and clinical experience in open carpal tunnel release for treatment of the carpal tunnel syndrome.Methods We retrospectfully analyse the data of the 137 patients who are diagnosed with the carpal tunnel syndrome from July 2013 to September 2016 in our hospital.There are 37 males and 100 females among the data.The age level ranges from 22 to 85 years old and the average age is 55.4 years old.There are 191 hands totally,including 77 left hands,113 right hand and bilateral 53.According to the Gu Classification,all patiants are moderate to severe level,which contains 31 moderate level patiants and 106 severe level patients.All of them underwent the carpal tunnel release.47 patients use "S" incision and 90 patients use straight incision.There are 73 patients conducting the corticosteroid injection beneath the epineurium,56 patients operating the release of the median nerve epineurium,29 patients doing the recurrent branch of median nerve releasing and 2 patients with the palmar function reconstruction in the first operation.Results 82 patients(moderate level 19 cases,severe level 63 cases)were followed-up for 6-30 months.According to the function evaluation trial standards of the upper extremity peripheral nerve from the Hand Surgery Organization of Chinese Medical Association,Excellent results were covered in 25 cases(moderate level 18 cases,severe level 7 cases),good in 39 cases(moderate level 1cases,severe level 38 cases),fair in 15 cases(no moderate level case,severe level 15 cases),and the poor in 3case(no moderate level case,severe level 3 cases).The total rate of excellent and good is about 78 percent.According to whether they were doing the electromyography examination before the surgery,the choice of the surgical incision,whether there were releasing the median nerve epineurium,whether they were injecting corticosteroid under the median nerve,whether they were operating the recurrent branch of the median nerve release,we divided all of them into two groups.We can conclude via the software SPSS 21.0 that the comparision of exellent and good rate between release of the recurrent branch of the median nerve group and no release of the recurrent branch of the median nerve,p=0.036<0.05,it has statistical significance.For other forms of binary classification,the p is greater than 0.05,there are no statistical significance.Conclusion Open carpal tunnel release is an effective surgical method,statistical association has not been found between the effect of the surgery and shape of the incision,median nerve epineurium release,corticosteroid injection beneath the median nerve epineurium.It is meaningful for preoperative clinical classification to guide the surgical treatment.For the patiens with severe carpal tunnel syndrome,it is significative to release the recurrent branch of the median nerve.We don’t consider operating the palmar function reconstruction surgery to the patients with an atrophy of the thenar muscle in their first operation.