Retinaculotomía endoscópica de doble portal en el síndrome del túnel carpiano
Barra lateral del artículo
Publicado:
nov 18, 2020
Palabras clave:
Síndrome del túnel carpiano, técnica de doble portal de Chow, liberación endoscópica, compresión neural, nervio mediano
Contenido principal del artículo
Resumen
Objetivo: Evaluar los resultados de la retinaculotomía endoscópica para tratar el síndrome del túnel carpiano mediante la técnica de doble portal de Chow, entre enero de 2006 y diciembre de 2015. Materiales y Métodos: Estudio de 179 pacientes (edad promedio 48.2 años [rango 32-68]), con 217 casos de síndrome del túnel carpiano idiopático y un seguimiento promedio de 97.9 meses. Los pacientes eran 145 mujeres (81%) (31 bilaterales) y 34 hombres (19%) (7 bilaterales) y fueron evaluados con la Symptom Severity Scale (SSS) y la Functional Status Scale (FSS) del Boston Carpal Tunnel Questionnaire (BCTQ). Resultados: El puntaje medio de la SSS-BCTQ fue de 3,20 + 0,26 antes de la cirugía, mejoró a 1,30 + 0,12 a los 6 meses y se mantuvo en 1,25+ 0,11 a largo plazo. El puntaje medio de la FSS-BCTQ fue de 2,57 + 0,29 antes de la cirugía, mejoró a 1,28 + 0,18 a los 6 meses y se mantuvo en 1,20 + 0,09 a largo plazo. Hubo 7 casos (3,2%) de neuropraxia posquirúrgica transitoria. No hubo conversiones a técnica abierta. Conclusión: La liberación endoscópica del túnel carpiano con la técnica de Chow es un método quirúrgico eficaz y seguro para tratar el síndrome del túnel carpiano idiopático.
Palabras clave: Síndrome del túnel carpiano; técnica de doble portal de Chow; liberación endoscópica; compresión neural; nervio mediano.
Nivel de Evidencia: III
Palabras clave: Síndrome del túnel carpiano; técnica de doble portal de Chow; liberación endoscópica; compresión neural; nervio mediano.
Nivel de Evidencia: III
Descargas
La descarga de datos todavía no está disponible.
Métricas
Cargando métricas ...
Detalles del artículo
Cómo citar
Ojeda, Álvaro C., Contreras, V. A., & Sanzana, E. S. (2020). Retinaculotomía endoscópica de doble portal en el síndrome del túnel carpiano. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 85(4), 349-356. https://doi.org/10.15417/issn.1852-7434.2020.85.4.1062
Número
Sección
Investigación Clínica
Derechos de autor 2020 Revista de la Asociación Argentina de Ortopedia y Traumatología
La aceptación del manuscrito por parte de la revista implica la no presentación simultánea a otras revistas u órganos editoriales. La RAAOT se encuentra bajo la licencia Creative Commons 4.0. Atribución-NoComercial-CompartirIgual (http://creativecommons.org/licenses/by-nc-sa/4.0/deed.es). Se puede compartir, copiar, distribuir, alterar, transformar, generar una obra derivada, ejecutar y comunicar públicamente la obra, siempre que: a) se cite la autoría y la fuente original de su publicación (revista, editorial y URL de la obra); b) no se usen para fines comerciales; c) se mantengan los mismos términos de la licencia.
En caso de que el manuscrito sea aprobado para su próxima publicación, los autores conservan los derechos de autor y cederán a la revista los derechos de la publicación, edición, reproducción, distribución, exhibición y comunicación a nivel nacional e internacional en las diferentes bases de datos, repositorios y portales.
Se deja constancia que el referido artículo es inédito y que no está en espera de impresión en alguna otra publicación nacional o extranjera.
Por la presente, acepta/n las modificaciones que sean necesarias, sugeridas en la revisión por los pares (referato), para adaptar el trabajo al estilo y modalidad de publicación de la Revista.
Citas
1. Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosen I. Prevalence of carpal tunnel syndrome in a
general population. JAMA 1999;282(2):153-8. https://doi.org/10.1001/jama.282.2.153
2. Paget J. Lectures on surgical pathology: Delivered at the Royal College of Surgeons of England. 2d American ed. Philadelphia: Lindsay & Blakiston; 1854:42-3.
3. Learmonth JR. The principle of decompression in the treatment of certain diseases of peripheral nerves. Surg Clin North Am 1933;13:905-13.
4. Rodner CM, Katrincic J. Open carpal tunnel release. Tech Orthop 2006;21(1):3-11.
https://doi.org/10.1097/01.bto.0000220086.17351.e2
5. Kluge W, Simpson R, Nicol A. Late complications after open carpal tunnel decompression. J Hand Surg Br 1996;
21(2):205-7. https://doi.org/10.1016/s0266-7681(96)80098-2
6. Boya H, Özcan Ö, Özteki N. Long-term complications of open carpal tunnel release. Muscle Nerve 2008;38(5):
1443-6. https://doi.org/10.1002/mus.21068
7. Okutsu I, Ninomiya S, Takatori Y, Ugawa Y. Endoscopic management of the carpal tunnel syndrome. Arthroscopy 1989;5(1):11-8. https://doi.org/10.1016/0749-8063(89)90084-4
8. Chow JC. Endoscopic release of the carpal ligament: a new technique for carpal tunnel syndrome. Arthroscopy
1989;5(1):19-24. https://doi.org/10.1016/0749-8063(89)90085-6
9. Agee JM, McCarroll HR, Tortosa RD, Berry DA, Szabo RM, Peimer CA. Endoscopic release of the carpal tunnel: a
randomized prospective multicenter study. J Hand Surg Am 1992;17(6):987-95. https://doi.org/10.1016/s0363-5023(09)91044-9
10. Brown MG, Keyser B, Rothenberg ES. Endoscopic carpal tunnel release. J Hand Surg Am 1992;17(6):1009-11.
https://doi.org/10.1016/S0363-5023(09)91047-4
11. Chow JC. The Chow technique of endoscopic release of the carpal ligament for carpal tunnel syndrome: four years of clinical results. Arthroscopy 1993;9(3):301-14. https://doi.org/10.1016/s0749-8063(05)80426-8
12. Atroshi I, Larsson GU, Ornstein E, Hofer M, Johnsson R, Ranstam J. Outcomes of endoscopic surgery compared with open surgery for carpal tunnel syndrome among employed patients: randomised controlled trial. BMJ 2006;24:332 (7556):1473. https://doi.org/10.1136/bmj.38863.632789.1F
13. Atroshi I, Hofer M, Larsson GU, Ornstein E, Johnsson R, Ranstam J. Open compared with 2-portal endoscopic
carpal tunnel release: a 5-year follow-up of a randomized controlled trial. J Hand Surg Am 2009;34(2):266-72.
https://doi.org/10.1016/j.jhsa.2008.10.026
14. Okutsu I, Hamanaka I, Yoshida A. Retrospective analysis of five-years and longer clinical and electrophysiological results of the world’s first endoscopic management for carpal tunnel syndrome. Hand Surg 2013;18(3):317-23. https://doi.org/10.1142/S0218810413500330
15. Sayegh ET, Strauch RJ. Open versus endoscopic carpal tunnel release: a meta-analysis of randomized controlled trials. Clin Orthop Relat Res 2015;473(3):1120-32. https://doi.org/10.1007/s11999-014-3835-z
16. Argüelles S, Rodriguez M, Soutullo J, Santos G, Gelo M, Pereira E. Descompresión endoscópica del túnel carpiano. Resultados y complicaciones en 126 casos. Artroscopía 2018;25(4):131-5. https://www.revistaartroscopia.com.ar/ediciones-anteriores/images/artroscopia/volumen-25-nro-4/25_04_05_Arguelles/25_04_Arguelles.pdf
17. Chow JCY, Papachristos AA. Endoscopic carpal tunnel release: Chow technique. Tech Orthop 2006;21(1):19-29.
https://doi.org/10.1097/01.bto.0000221927.44752.6e
18. Sanz-Reig J, Lizaur-Utrilla A, Sanchez del Campo F, Maqueda-Abreu V. Estudio ecográfico del síndrome del túnel del carpo en la mujer. Rev Esp Cir Ortop Traumatol 2004;48(3):201-4. https://doi.org/10.1016/S1888-4415(04)76197-4
19. Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, et al. A self-administered questionnaire
for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am 1993;75(11):1585-92. https://doi.org/10.2106/00004623-199311000-00002
20. Tulipan JE, Kim N, Ilyas AM, Matzon JL. Endoscopic carpal tunnel release with and without sedation. Plast
Reconstr Surg 2018;141(3):685-690. https://doi.org/10.1097/PRS.0000000000004113
21. Nath RK, Mackinnon SE, Weeks PM. Ulnar nerve transection as a complication of two-portal endoscopic carpal
tunnel release: a case report. J Hand Surg Am 1993;18(5):896-8. https://doi.org/10.1016/0363-5023(93)90063-9
22. Murphy RX, Jennings JF, Wukich DK. Major neurovascular complications of endoscopic carpal tunnel release.
J Hand Surg Am 1994;19(1):114-8. https://doi.org/10.1016/0363-5023(94)90233-X
23. De Smet L, Fabry G. Transection of the motor branch of ulnar nerve as a complication of two-portal endoscopic carpal tunnel release: a case report. J Hand Surg Am 1995;20(1):18-9. https://doi.org/10.1016/s0363-5023(05)80050-4
24. Ryu SJ, Kim IS. Pseudoaneurysm of ulnar artery after endoscopic carpal tunnel release. J Korean Neurosurg Soc 2010;48(4):380-2. https://doi.org/10.3340/jkns.2010.48.4.380
25. Chow JC, Hantes ME. Endoscopic carpal tunnel release: thirteen years’ experience with the Chow technique.
J Hand Surg Am 2002;27(6):1011-8. https://doi.org/10.1053/jhsu.2002.35884
26. Oertel J, Schroeder HWS, Gaab MR. Dual-portal endoscopic release of the transverse ligament in carpal tunnel
syndrome: result of 411 procedures with special reference to technique, efficacy, and complications. Neurosurgery 2006;59(2):333-40. https://doi.org/10.1227/01.NEU.0000223500.25131.99
27. Hankins CL, Brown MG, Lopez RA, Lee AK, Dang J, Harper RD. A 12-year experience using the Brown two-portal endoscopic procedure of transverse carpal release in 14.722 patients. Plast Reconstr Surg 2007;120(7):1911-21. https://doi.org/10.1097/01.prs.0000287287.85044.87
28. Uchiyama S, Nakamura K, Itsubo T, Murakami H, Hayashi M, Imaeda T, et al. Technical difficulties and their
prediction in 2-portal endoscopic carpal tunnel release for idiopathic carpal tunnel syndrome. Arthroscopy
2013;29(5):860-9. https://doi.org/10.1016/j.arthro.2013.01.027
29. Vasiliadis HS, Georgoulas P, Shrier I, Salanti G, Scholten RJPM. Endoscopic release for carpal tunnel syndrome.
Cochrane Database Sys Rev 2014;(1):CD008265. https://doi.org/10.1002/14651858.CD008265.pub2
30. Ip WJ, Sweed T, Fung KKB, Tipoe G, Pun TS. A new technique of single portal endoscopic carpal tunnel release.
Tech Hand Up Extrem Surg 2012;16(1):27-9. https://doi.org/10.1097/BTH.0b013e318230db42
31. Ecker J, Perera N, Ebert J. Supraretinacular endoscopic carpal tunnel release: surgical technique with prospective case series. J Hand Surg Eur 2015;40(2):193-8. https://doi.org/10.1177/1753193414524688
32. Teh KK, Choo CH, Shanmugam R, Ngim JH, Ahmad TS. A novel supraretinacular endoscopic carpal tunnel release: Instrumentation and technique (cadaveric study). J Hand Surg Global Online 2019;1(4):222-5.
https://doi.org/10.1016/j.jhsg.2019.07.003
general population. JAMA 1999;282(2):153-8. https://doi.org/10.1001/jama.282.2.153
2. Paget J. Lectures on surgical pathology: Delivered at the Royal College of Surgeons of England. 2d American ed. Philadelphia: Lindsay & Blakiston; 1854:42-3.
3. Learmonth JR. The principle of decompression in the treatment of certain diseases of peripheral nerves. Surg Clin North Am 1933;13:905-13.
4. Rodner CM, Katrincic J. Open carpal tunnel release. Tech Orthop 2006;21(1):3-11.
https://doi.org/10.1097/01.bto.0000220086.17351.e2
5. Kluge W, Simpson R, Nicol A. Late complications after open carpal tunnel decompression. J Hand Surg Br 1996;
21(2):205-7. https://doi.org/10.1016/s0266-7681(96)80098-2
6. Boya H, Özcan Ö, Özteki N. Long-term complications of open carpal tunnel release. Muscle Nerve 2008;38(5):
1443-6. https://doi.org/10.1002/mus.21068
7. Okutsu I, Ninomiya S, Takatori Y, Ugawa Y. Endoscopic management of the carpal tunnel syndrome. Arthroscopy 1989;5(1):11-8. https://doi.org/10.1016/0749-8063(89)90084-4
8. Chow JC. Endoscopic release of the carpal ligament: a new technique for carpal tunnel syndrome. Arthroscopy
1989;5(1):19-24. https://doi.org/10.1016/0749-8063(89)90085-6
9. Agee JM, McCarroll HR, Tortosa RD, Berry DA, Szabo RM, Peimer CA. Endoscopic release of the carpal tunnel: a
randomized prospective multicenter study. J Hand Surg Am 1992;17(6):987-95. https://doi.org/10.1016/s0363-5023(09)91044-9
10. Brown MG, Keyser B, Rothenberg ES. Endoscopic carpal tunnel release. J Hand Surg Am 1992;17(6):1009-11.
https://doi.org/10.1016/S0363-5023(09)91047-4
11. Chow JC. The Chow technique of endoscopic release of the carpal ligament for carpal tunnel syndrome: four years of clinical results. Arthroscopy 1993;9(3):301-14. https://doi.org/10.1016/s0749-8063(05)80426-8
12. Atroshi I, Larsson GU, Ornstein E, Hofer M, Johnsson R, Ranstam J. Outcomes of endoscopic surgery compared with open surgery for carpal tunnel syndrome among employed patients: randomised controlled trial. BMJ 2006;24:332 (7556):1473. https://doi.org/10.1136/bmj.38863.632789.1F
13. Atroshi I, Hofer M, Larsson GU, Ornstein E, Johnsson R, Ranstam J. Open compared with 2-portal endoscopic
carpal tunnel release: a 5-year follow-up of a randomized controlled trial. J Hand Surg Am 2009;34(2):266-72.
https://doi.org/10.1016/j.jhsa.2008.10.026
14. Okutsu I, Hamanaka I, Yoshida A. Retrospective analysis of five-years and longer clinical and electrophysiological results of the world’s first endoscopic management for carpal tunnel syndrome. Hand Surg 2013;18(3):317-23. https://doi.org/10.1142/S0218810413500330
15. Sayegh ET, Strauch RJ. Open versus endoscopic carpal tunnel release: a meta-analysis of randomized controlled trials. Clin Orthop Relat Res 2015;473(3):1120-32. https://doi.org/10.1007/s11999-014-3835-z
16. Argüelles S, Rodriguez M, Soutullo J, Santos G, Gelo M, Pereira E. Descompresión endoscópica del túnel carpiano. Resultados y complicaciones en 126 casos. Artroscopía 2018;25(4):131-5. https://www.revistaartroscopia.com.ar/ediciones-anteriores/images/artroscopia/volumen-25-nro-4/25_04_05_Arguelles/25_04_Arguelles.pdf
17. Chow JCY, Papachristos AA. Endoscopic carpal tunnel release: Chow technique. Tech Orthop 2006;21(1):19-29.
https://doi.org/10.1097/01.bto.0000221927.44752.6e
18. Sanz-Reig J, Lizaur-Utrilla A, Sanchez del Campo F, Maqueda-Abreu V. Estudio ecográfico del síndrome del túnel del carpo en la mujer. Rev Esp Cir Ortop Traumatol 2004;48(3):201-4. https://doi.org/10.1016/S1888-4415(04)76197-4
19. Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, et al. A self-administered questionnaire
for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am 1993;75(11):1585-92. https://doi.org/10.2106/00004623-199311000-00002
20. Tulipan JE, Kim N, Ilyas AM, Matzon JL. Endoscopic carpal tunnel release with and without sedation. Plast
Reconstr Surg 2018;141(3):685-690. https://doi.org/10.1097/PRS.0000000000004113
21. Nath RK, Mackinnon SE, Weeks PM. Ulnar nerve transection as a complication of two-portal endoscopic carpal
tunnel release: a case report. J Hand Surg Am 1993;18(5):896-8. https://doi.org/10.1016/0363-5023(93)90063-9
22. Murphy RX, Jennings JF, Wukich DK. Major neurovascular complications of endoscopic carpal tunnel release.
J Hand Surg Am 1994;19(1):114-8. https://doi.org/10.1016/0363-5023(94)90233-X
23. De Smet L, Fabry G. Transection of the motor branch of ulnar nerve as a complication of two-portal endoscopic carpal tunnel release: a case report. J Hand Surg Am 1995;20(1):18-9. https://doi.org/10.1016/s0363-5023(05)80050-4
24. Ryu SJ, Kim IS. Pseudoaneurysm of ulnar artery after endoscopic carpal tunnel release. J Korean Neurosurg Soc 2010;48(4):380-2. https://doi.org/10.3340/jkns.2010.48.4.380
25. Chow JC, Hantes ME. Endoscopic carpal tunnel release: thirteen years’ experience with the Chow technique.
J Hand Surg Am 2002;27(6):1011-8. https://doi.org/10.1053/jhsu.2002.35884
26. Oertel J, Schroeder HWS, Gaab MR. Dual-portal endoscopic release of the transverse ligament in carpal tunnel
syndrome: result of 411 procedures with special reference to technique, efficacy, and complications. Neurosurgery 2006;59(2):333-40. https://doi.org/10.1227/01.NEU.0000223500.25131.99
27. Hankins CL, Brown MG, Lopez RA, Lee AK, Dang J, Harper RD. A 12-year experience using the Brown two-portal endoscopic procedure of transverse carpal release in 14.722 patients. Plast Reconstr Surg 2007;120(7):1911-21. https://doi.org/10.1097/01.prs.0000287287.85044.87
28. Uchiyama S, Nakamura K, Itsubo T, Murakami H, Hayashi M, Imaeda T, et al. Technical difficulties and their
prediction in 2-portal endoscopic carpal tunnel release for idiopathic carpal tunnel syndrome. Arthroscopy
2013;29(5):860-9. https://doi.org/10.1016/j.arthro.2013.01.027
29. Vasiliadis HS, Georgoulas P, Shrier I, Salanti G, Scholten RJPM. Endoscopic release for carpal tunnel syndrome.
Cochrane Database Sys Rev 2014;(1):CD008265. https://doi.org/10.1002/14651858.CD008265.pub2
30. Ip WJ, Sweed T, Fung KKB, Tipoe G, Pun TS. A new technique of single portal endoscopic carpal tunnel release.
Tech Hand Up Extrem Surg 2012;16(1):27-9. https://doi.org/10.1097/BTH.0b013e318230db42
31. Ecker J, Perera N, Ebert J. Supraretinacular endoscopic carpal tunnel release: surgical technique with prospective case series. J Hand Surg Eur 2015;40(2):193-8. https://doi.org/10.1177/1753193414524688
32. Teh KK, Choo CH, Shanmugam R, Ngim JH, Ahmad TS. A novel supraretinacular endoscopic carpal tunnel release: Instrumentation and technique (cadaveric study). J Hand Surg Global Online 2019;1(4):222-5.
https://doi.org/10.1016/j.jhsg.2019.07.003