Comparison between single portal endoscopic and 1-cm open carpal tunnel release.

Given the controversy about the best surgical technique for carpal tunnel release, this study tested the hypothesis that no significant differences would be observed between single-portal endoscopic release and a short, 1-cm incision open release in a large sample of patients. Consecutive patients were assigned to one of the two techniques. Preoperative and postoperative measurements included grip and pinch strength, a visual analog scale for pain and a satisfaction questionnaire. Eighty-seven patients completed the study: 35 with an endoscopic release and 52 with an open release. Both techniques were effective and safe: grip and pinch strength decreased 1 month after surgery in both techniques but improved significantly at 6 and 12 months (P < 0.05) while the complication rate was low. Subjective results were judged to be "excellent or good" by more than 90% of patients in both groups. No significant between-technique differences in outcomes were observed thus, surgical decisions may be based on criteria other than effectiveness. LEVEL OF EVIDENCE: Level IV; Case Series; Treatment Study.

Complicaciones y secuelas de la cirugía de los radios segundo a quinto del pie / Complications and sequelae of second to fifth ray surgery

Introducción. Los radios menores también requieren ser intervenidos quirúrgicamente en la cirugía primaria para solucionar metatarsalgias transferenciales o luxaciones metatarsofalángicas, así como la patología del quinto radio.Complicaciones y tratamiento. Las complicaciones puedenpresentarse por mala indicación quirúrgica, incorrecta planificación, errores de técnica o cuidados posoperatorios inadecuados. Las técnicas quirúrgicas correctas serán diferentes según el radio que esté afectado o según el nivel. La rigidez, las recidivas de la deformidad, la hipercorrección y las metatarsalgias por sobrecarga son quizás las más frecuentes.Es este artículo se exponen los diferentes procedimientosutilizados habitualmente para la corrección de estassecuelas

Introduction. The lesser toes sometimes require primarysurgery to address transfer metatarsalgias, metatarsophalangeal dislocations or some specific pathologies affecting the second to the fifth toe.Complications and treatment. Complications can occur because of a poor surgical indication, poor planning, technical errors or inappropriate postoperative care. Surgical techniques will vary depending on which toe is affected and on the level involved. Stiffness, deformity relapses, hypercorrection and overload metatarsalgia are probably the most frequent complications. This paper reviews the different surgical procedures commonly used to correct the above mentioned sequelae