Scar quality after an open decompression of median nerve

Abstract

Sindrom karpalnog kanala (SKT) je kronična kompresivna neuropatija nervusa medijanusa u ručnom zglobu te obuhvaća 90% svih perifernih kompresivnih neuropatija. Najčešće nastupa u srednjim godinama, češće u žena. Najvažniji predisponirajući faktori rizika su spol, dob te genetički i antropometrijski faktori. U najvećem broju slučajeva sindrom karpalnog kanala je idiopatska bolest čiji simptomi perzistiraju mjesecima pa čak i godinama. U ispravnom postavljanju dijagnoze najvažniji je EMNG nalaz koji pokazuje usporenu motoričku i osjetnu provodnost u području ručnog zgloba u ranoj fazi bolesti, za razliku od kasne faze u kojoj mišići pokazuju jasne znakove denervacije. Zbog toga, iako postoje mogućnosti konzervativnog oblika liječenja, većina rezistentnih bolesnika se na kraju odlučuje za kirurški tretman koji u više od 95% slučajeva dovodi do trajnog olakšanja simptoma. Danas se najčešće izvodi tzv. otvorena operacija koja se sastoji u presijecanju transverzalnog karpalnog ligamenta. Ovim radom pokušali smo dokazati kako kratki uzdužni rez rezultira funkcionalnim i estetski prihvatljivim ožiljkom. Analizirali smo preoperativne i postoperativne simptome te kvalitetu ožiljka kod 33 bolesnika operirana zbog sindroma karpalnog kanala. Dobiveni podaci ukazuju da se upotrebom kratke uzdužne incizije postiže dugoročno adekvatna dekompresija nervusa medijanusa uz prihvatljivu kvalitetu postoperacijskog ožiljka.Carpal Tunnel Syndrome (CTS) is a chronic compressive neuropathy of the median nerve in the wrist and encompasses 90% of all peripheral compressive neuropathies. Most commonly occurs in middle age, more often in women. The most important predisposing risk factors are sex, age and genetic and anthropometric factors. In most cases, carpal tunnel syndrome is an idiopathic illness whose symptoms persist for months and even years. In the correct diagnosis setting, the most important is the EMNG finding that shows slow motor and sensory conductance in the wrist area at an early stage of the disease, unlike the late phase in which the muscles show clear signs of denervation. Therefore, although there are opportunities for conservative treatment, most resistant patients are ultimately selected for surgical treatment that in more than 95% of cases leads to permanent relief of symptoms. Today, the most commonly performed is the so-called open operation consisting in the transection of the transverse carpal ligament. With this work we tried to prove how short longitudinal cut results in a functional and aesthetically acceptable scarring. We analyzed preoperative and postoperative symptoms and scarring quality in 33 patients operated due to carpal tunnel syndrome. The obtained data indicate that adequate long-term decompression of median nerve is achieved by using the short-long incision with acceptable postoperative scarring quality