小皮切手根管開放術の治療成績

Outcome of Open Carpal Tunnel Release through a Small Skin Incision

　目的：特発性手根管症候群に対する小皮切開放術の成績を報告する．対象・方法：対象35例38手，性別男性8例，女性27例，年齢平均61歳であった．術前浜田分類でGrade Ⅰ 7手，Ⅱ 28手，Ⅲ 3手であった．検討項目では成績を浜田基準で，自覚症状をVASで評価した．結果：Grade Ⅰ ではGood 4手，Fair 3手，Grade Ⅱ ではGood 25手，Fair 3手，Grade Ⅲ ではGood 2手，Fair 1手でありPoorの症例はなかった．合併症はなかった．考察：本術式は手技が容易で安全，確実であり，直視下に神経の除圧を確認することが可能など有用と考えられた．

　Objective：To report the outcome of treatment of idiopathic carpal tunnel syndrome by open release through a small skin incision. Subjects and methods：A total of 38 hands of 35 patients (8 men and 27 women；mean age, 61 years) were evaluated. The hands were preoperatively graded according to the Hamada classification as follows：7, Grade Ⅰ；28, Grade Ⅱ；and 3, Grade Ⅲ. Outcome was evaluated by using the Hamada classification, and symptoms were assessed by means of a VAS. Results：The outcome was classified as Good in 4 hands and Fair in 3 hands in Grade Ⅰ, Good in 25 and Fair in 3 in Grade Ⅱ, and Good in 2 and Fair in 1 in Grade Ⅲ. No outcomes were classified as Poor. No complications were observed during or after surgery. Observation：Based on its ease, safety, reliability and the ability to directly confirm nerve decompression by visual inspection, this technique is concluded to be an effective means of treatment for carpal tunnel syndrome.