THE OUTCOME OF RETINACULOTOMY FOR CARPAL TUNNEL SYNDROME AT NORTHWEST GENERAL HOSPITAL AND RESEARCH CENTER PESHAWAR
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Keywords
Flexor Retinaculotomy, Carpal Tunnel Release, local anesthesia
Abstract
Objective: The objective of this study is to know the functional outcome of Flexor Retinaculotomy for Carpal Tunnel Syndrome in our part of the world by local anesthesia.
Methods: This prospective study was carried out after ethical approval, from August 2022 to August 2023, at Northwest General Hospital and Research Center in Peshawar, Pakistan.
Total patients included in the study were 48, all having bilateral Carpal Tunnel Release (CTR), so the total number of CTRs performed are 98. The diagnosis of CTS was made by clinical examination and confirmation by Nerve Conduction Studies (NCS). Findings included median nerve distribution numbness, nocturnal paresthesia, thenar muscle weakening and atrophy may or not be present, positive Tinel's sign, and/or painful Phalen's maneuver. NCS were also used to undertake electrodiagnostic confirmation of the diagnosis. All patients' NCS data supported mild to severe CTS.
Results: Total number of CTRs performed are 98 having mostly (89%) female patients and less (11%) male patients. Patients’ ages ranged from 15-68 years with a mean age of 41 years. Improvement in pinch grip was assessed using the MRC grading system. It was believed that a typical pinch grip had 5/5 power, whilst a weak pinch grasp had 4/5+ power.
Pinch grip improved up to 51% by 2nd week and 100% by 4th week.
Conclusion: Carpal tunnel release with standard 3-4cm longitudinal incision has good functional outcome in terms of pinch grip, opposition, return to work, pain and paresthesia of the fingers.
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Waseem Dad Khan
Registrar Neurosurgery, Northwest General Hospital and Research Center, Peshawar.
Ahmad Reshad Payenda
Post Graduate Resident (Neurosurgery), Northwest General Hospital and Research Center, Peshawar.
Faiqa Filza
Associate Professor and Consultant Neurosurgeon, Northwest General Hospital and Research Center, Peshawar.
Wasim Khan
Post Graduate Resident (Orthopedic Surgery), Northwest General Hospital and Research Center, Peshawar.
Sohail Daud Khan
Registrar Neurosurgery, Northwest General Hospital and Research Center, Peshawar.
Irfan Jan
Registrar Neurosurgery, Northwest General Hospital and Research Center, Peshawar.
Khial Jalal
Registrar Neurosurgery, Northwest General Hospital and Research Center, Peshawar.
Naqeeb Ullah
Post Graduate Resident (Neurosurgery), Northwest General Hospital and Research Center, Peshawar.
Wajid Ali
Post Graduate Resident (General Surgery), Northwest General Hospital and Research Center, Peshawar.
Shehza Hashmat
Post Graduate Resident (Neurosurgery), Northwest General Hospital and Research Center, Peshawar.